title: Individual budgets for people with incontinence: results from a 'shopping' experiment within the British National Health Service.
abstract: BACKGROUND
  Most people with urinary incontinence are given limited choice when provided with absorbent products through the British National Health Service (NHS), even though the available range is large.
  
  
  OBJECTIVE
  To investigate users' preferences for four disposable designs (inserts, all-in-ones, belted/T-shaped and pull-ups) and towelling washable/reusable products, day and night.
  
  
  METHODS
  Shopping experiment.
  
  
  METHODS
  Community-dwelling women and men in England with moderate-to-heavy urinary incontinence recruited to a larger trial.
  
  
  METHODS
  Participants tested each design and selected products they would prefer with a range of different budgets.
  
  
  METHODS
  Design preferences (rankings); 'purchasing' decisions from designated budgets. Results  Eighty-five participants (49 men) tested products, 75 completed the shopping experiment. Inserts, most frequently supplied by the NHS, were ranked second to pull-ups by women and lowest by men. When faced with budget constraints, up to 40% of participants opted to 'mix-and-match' designs. Over 15 different combinations of products were selected by participants in the shopping experiment. Most (91%) stated a willingness to 'top-up' assigned budgets from income to secure preferred designs.
  
  
  CONCLUSIONS
  Participants displayed diverse preferences. Enabling user choice of absorbent product design through individual budgets could improve satisfaction of consumers and efficiency of allocation of limited NHS resources.
  
  
  CONCLUSIONS
  Recent policy for the NHS seeks to provide consumers with more control in their care. Extension of the concept of individual budgets to continence supplies could be feasible and beneficial for patients and provide better value-for-money within the NHS. Further research is warranted.
authors.affiliation: Professor, Faculty of Health Sciences, University of Southampton, SouthamptonProfessor, Department of Medical Physics, University College London, Archway Campus, Highgate Hill, LondonReader, Department of Economics, University of Surrey, Guildford, UKStatistical Consultant, Department of Mathematics, University of Surrey, Guildford, UKProfessor (Retired), Faculty of Health Sciences, University of Southampton, SouthamptonResearch Fellow, Department of Medical Physics, University College London, Archway Campus, Highgate Hill, London, UK.
authors.forename: Mandy J
authors.initials: MJ
authors.lastname: Fader
authors.forename: Alan M
authors.initials: AM
authors.lastname: Cottenden
authors.forename: Heather M
authors.initials: HM
authors.lastname: Gage
authors.forename: Peter
authors.initials: P
authors.lastname: Williams
authors.forename: Katharine
authors.initials: K
authors.lastname: Getliffe
authors.forename: Sinead
authors.initials: S
authors.lastname: Clarke-O'Neill
authors.forename: Katharine M
authors.initials: KM
authors.lastname: Jamieson
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Green
mesh_terms: D000328:Adult; D004739:England; D005260:Female; D006801:Humans; D016496:Incontinence Pads / Q000145:classification* / Q000191:economics*; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D012959:Socioeconomic Factors; D013222:State Medicine / Q000706:statistics & numerical data*; D014549:Urinary Incontinence / Q000191:economics*