EAPSI: Measuring Public Preferences for Prioritizing Health Services under Taiwan?s National Health Insurance System

Schoon Rebecca L, Portland OR

Investigators

Abstract

All health systems struggle with unlimited needs for health care, yet limited resources with which to address them. Under national health insurance systems, policymakers have recognized the need to include public values in decisions around distributing funding and other resources across health priorities. Given the complex nature of these decisions, however, research into how to effectively measure public preferences is underdeveloped. Measuring community values poses special challenges since they involve personal opinions that can be interpreted differently across individuals and communities. This study will test a new method to promote community participation in health policymaking. The project will integrate two established methods for measuring community values, Discrete Choice Experiments (DCEs) and Citizens Juries (CJs), with the aim of maximizing their respective strengths. This research will be conducted in collaboration with Dr. Tsai-Ching Liu, a health economist and chairwoman of the Department of Public Finance at National Taipei University in Taipei, Taiwan. Advancing these methods can assist national health insurance systems to better reflect the priorities and concerns of the populations they serve. The study?s first objective is to evaluate differences in preferences when solicited through individual quantitative surveys (DCEs) versus an informed, dialogue-based group setting (CJs). The second objective is to test methodological issues in the integration of DCEs and CJs, including issues of representation and validity. This methodology is innovative in incorporating three traits that are critical to engaging the public in priority setting: i) exposing community participants to relevant technical information, ii) testing ideas and values across community members with diverse backgrounds and perspectives, and iii) providing quantifiable data compatible with national priority setting tools. The results of this study will offer an innovative research framework for the design of health systems that meaningfully represent community preferences, which is critical for public acceptance in democracies. This award under the East Asia and Pacific Summer Institutes program supports summer research by a U.S. graduate student and is jointly funded by NSF and the Ministry of Science and Technology of Taiwan.