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Data on Health Insurance Detailed by Researchers at World Bank (Developing attributes and attribute-levels for a discrete choice experiment on micro...

June 30, 2014

Data on Health Insurance Detailed by Researchers at World Bank (Developing attributes and attribute-levels for a discrete choice experiment on micro health insurance in rural Malawi)

By a News Reporter-Staff News Editor at Clinical Trials Week -- Data detailed on Health Insurance have been presented. According to news reporting originating from Washington, District of Columbia, by NewsRx correspondents, research stated, "Discrete choice experiments (DCEs) are attribute-driven experimental techniques used to elicit stakeholders' preferences to support the design and implementation of policy interventions. The validity of a DCE, therefore, depends on the appropriate specification of the attributes and their levels."

Our news editors obtained a quote from the research from World Bank, "There have been recent calls for greater rigor in implementing and reporting on the processes of developing attributes and attribute-levels for discrete choice experiments (DCEs). This paper responds to such calls by carefully reporting a systematic process of developing micro health insurance attributes and attribute-levels for the design of a DCE in rural Malawi. Conceptual attributes and attribute-levels were initially derived from a literature review which informed the design of qualitative data collection tools to identify context specific attributes and attribute-levels. Qualitative data was collected in August-September 2012 from 12 focus group discussions with community residents and 8 in-depth interviews with health workers. All participants were selected according to stratified purposive sampling. The material was tape-recorded, fully transcribed, and coded by three researchers to identify context-specific attributes and attribute-levels. Expert opinion was used to scale down the attributes and levels. A pilot study confirmed the appropriateness of the selected attributes and levels for a DCE. First, a consensus, emerging from an individual level analysis of the qualitative transcripts, identified 10 candidate attributes. Levels were assigned to all attributes based on data from transcripts and knowledge of the Malawian context, derived from literature. Second, through further discussions with experts, four attributes were discarded based on multiple criteria. The 6 remaining attributes were: premium level, unit of enrollment, management structure, health service benefit package, transportation coverage and copayment levels. A final step of revision and piloting confirmed that the retained attributes satisfied the credibility criteria of DCE attributes. This detailed description makes our attribute development process transparent, and provides the reader with a basis to assess the rigor of this stage of constructing the DCE."

According to the news editors, the research concluded: "This paper contributes empirical evidence to the limited methodological literature on attributes and levels development for DCE, thereby providing further empirical guidance on the matter, specifically within rural communities of low-and middle-income countries."

For more information on this research see: Developing attributes and attribute-levels for a discrete choice experiment on micro health insurance in rural Malawi. BMC Health Services Research, 2014;14():1-15. BMC Health Services Research can be contacted at: Biomed Central Ltd, 236 Grays Inn Rd, Floor 6, London WC1X 8HL, England. (BioMed Central -; BMC Health Services Research -

The news editors report that additional information may be obtained by contacting G.A. Abiiro, World Bank, Washington, DC 20433, United States. Additional authors for this research include G. Leppert, G.B. Mbera, P.J. Robyn and M. De Allegri (see also Health Insurance).

Keywords for this news article include: Washington, United States, Health Insurance, District of Columbia, North and Central America

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Source: Clinical Trials Week

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