Introduction: To meet the needs of aging individuals, governments need to expand the services and resources for long term care. The decision how to expand healthcare facilities, however, is a difficult one, because of the range of services that can be considered, the different modes in which such services can be provided, and the differences in need of potential beneficiaries. To guide such decisions, we have explored people's preferences for long-term care in a discrete choice experiment.
Methods: A general population sample (N=1082, aged 50 to 65) was asked to make choices over hypothetical care scenarios for a hypothetical patient. The choice set consisted of 256 paired choices of care scenarios, that were described by ten attributes (e.g. available facilities, mode of service delivery, and level of co-payment), each with 2 or 4 levels. The choice set was administrated with respect to 4 hypothetical patients: fragile elderly and patients with dementia, with and without partner. Data were analyzed using a logit model. To compare preferences across patient groups, the WTP was calculated.
Results: In general, people attributed high value to transportation services, and to the same person delivering care each time. Participation in organized social activities, and punctuality were considered less important. Singles and people with dementia were willing to pay more for long term care than fragile elderly and people living with a partner. An exception is transportation services, which was considered more important for fragile elderly. WTP was highest for people who combine these two risk factors. Dement people living without a partner also priority rank the services differently from the other groups (rank corr < 20%).
Conclusion: Decisions about the future of long-term care should take into account that different patient groups derive a different level of benefit from a particular service. The generated preference data allow for the development of policy models that offer the opportunity to balance the budgetary requirements of different services against the welfare that they produce for individuals.