title: Using time trade-off methods to assess preferences over health care delivery options: a feasibility study.
abstract: OBJECTIVE
  Time trade-off (TTO) methods are often used for utility assessments of different health states to measure quality of life (QOL). They have not generally been used to assess social preferences with respect to options for health care delivery, although the need for quantifying these preferences is arguably just as important. Policymakers are increasingly faced with decisions about how much to invest in, and how much to incentivize, particular modes of health care delivery, generally with little evidence about user preferences.
  
  
  METHODS
  This study draws on long-term care (LTC) delivery modes as an example. Focus groups were conducted to approach this issue both qualitatively and quantitatively. In a qualitative pilot study, two focus groups discussed issues of the LTC decision-making process and preferences among different LTC options. The TTO was then used to assess QOL for each LTC option, conditional on a specific health state, and then quantified user's LTC preferences by differential QOL between the two options.
  
  
  RESULTS
  This study found that the TTO-elicited utilities and their differences are consistent with the LTC preferences revealed from focus group discussions. These preferences depend on levels of disability and education.
  
  
  CONCLUSIONS
  The modified TTO technique seems a feasible method to quantify preferences over LTC delivery options. These methods may be applicable to various health care alternatives in which better evidence is needed to guide funding policy.
authors.affiliation: American Institutes for Research, Washington, DC, USA. Electronic address: jguo@air.org.
authors.forename: Jing
authors.initials: J
authors.lastname: Guo
authors.affiliation: University of Chicago, Chicago, IL, USA.
authors.forename: R Tamara
authors.initials: RT
authors.lastname: Konetzka
authors.affiliation: University of Chicago, Chicago, IL, USA.
authors.forename: William
authors.initials: W
authors.lastname: Dale
mesh_terms: D000328:Adult; D003657:Decision Making; D003695:Delivery of Health Care / Q000379:methods*; D004185:Disability Evaluation; D004522:Educational Status; D005240:Feasibility Studies; D017144:Focus Groups; D006291:Health Policy; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D057240:Patient Preference; D010865:Pilot Projects; D011050:Policy Making; D011788:Quality of Life; D013997:Time Factors
keywords: focus group study; long-term care; preference; time trade-off method