Date of Award

12-2009

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program

Health Outcomes and Policy Research

Research Advisor

Shelley White-Means, PhD

Committee

Dick R. Gourley, PharmD Nancy Mele, DNP Song Hee Hong, PhD Yi Yang, PhD

Keywords

CAM, Conjoint Analysis, Health Care, Osteoarthritis, Preferences, Willingness to Pay

Abstract

The design of this study is a non-random cross sectional survey to determine Medicare beneficiaries’ preferences and willingness to pay for osteoarthritis (OA) treatments. The population of interest in this study is the Medicare eligible (over age 65) population in Memphis, TN, and surrounding cities. Data were collected at Senior Centers and one internal medicine practice. The sample size was 181.

Choice-based conjoint analysis technique was utilized. The preferences and willingness to pay were determined using choice-based conjoint analysis, advanced design module with a dual-response none option. Choice-based conjoint analysis uses computer guided surveys to elicit patient preference for a series of comparisons of osteoarthritis treatments that are characterized differently.

This conjoint analysis study provides a greater understanding of how patients might incorporate complementary and alternative therapies into their osteoarthritis (OA) treatment regimen. This data enables clinicians and health care professionals to determine how patients may trade-off different levels of treatment attributes (e.g., cost, allopathic treatments, combination therapies, and Complementary and Alternative Medicine (CAM) therapies) for OA treatments.

Overall, for the total sample, prayer/spiritual healing had the highest utility value (.71). Therefore, all groups did not place higher utility on allopathic treatments over CAM treatments as hypothesized. When looking at product shares of preference, prayer/spiritual healing also had the highest share of preference (16.32%). When the sample was segmented by gender, women did not place higher utility on CAM treatments as hypothesized. They were slightly different, however. Males preferred herbal mineral supplements more than women (.39 vs. .01) and women preferred massage over men (.39 vs. -.06). Men and women had virtually the same negative utility values for chiropractic care and acupuncture, and the same positive utility values for prayer. When the sample was segmented by race, blacks did not place higher utility on CAM than whites, and whites did not place higher utility on allopathic treatments then blacks. However, whites did place higher utility on herbal/mineral supplements (.26 vs. .07) than blacks. As hypothesized blacks did place a higher utility on prayer/spiritual healing than did whites (1.56 vs.-0.03).

These data indicate that doctors and other healthcare providers should be encouraged to develop methods to involve patients in making treatment decisions and take the time to understand the patients’ treatment preferences. Patients in this sample desire treatments beyond the standard treatment protocol for osteoarthritis.

DOI

10.21007/etd.cghs.2009.0144

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