title: Equity and efficiency preferences of health policy makers in China--a stated preference analysis.
abstract: BACKGROUND
  Macroeconomic growth in China enables significant progress in health care and public health. It faces difficult choices regarding access, quality and affordability, while dealing with the increasing burden of chronic diseases. Policymakers are pressured to make complex decisions while implementing health strategies. This study shows how this process could be structured and reports the specific equity and efficiency preferences among Chinese policymakers.
  
  
  METHODS
  In total, 78 regional, provincial and national level policymakers with considerable experience participated in a discrete choice experiment, weighting the relative importance of six policy attributes describing equity and efficiency. Results from a conditional logistic model are presented for the six criteria, measuring the associated weights. Observed and unobserved heterogeneities were incorporated and tested in the model. Findings are used to give an example of ranking health interventions in relation to the present disease burden in China.
  
  
  RESULTS
  In general, respondents showed strong preference for efficiency criteria i.e. total beneficiaries and cost-effectiveness as the most important attributes in decision making over equity criteria. Hence, priority interventions would be those conditions that are most prevalent in the country and cost least per health gain.
  
  
  CONCLUSIONS
  Although efficiency criteria override equity ones, major health threats in China would be targeted. Multicriteria decision analysis makes explicit important trade-offs between efficiency and equity, leading to explicit, transparent and rational policy making.
authors.affiliation: Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Perth, WA, Australia & School of Economics, University of Bologna, Bologna, Italy, Economics Department, University of Southampton, Southampton, UK, Independent Consultant and Centre for Applied Health Research, Liverpool School of Tropical Medicine, L3 5PQ Liverpool and Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA f.paolucci@murdoch.edu.au.
authors.forename: Francesco
authors.initials: F
authors.lastname: Paolucci
authors.affiliation: Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Perth, WA, Australia & School of Economics, University of Bologna, Bologna, Italy, Economics Department, University of Southampton, Southampton, UK, Independent Consultant and Centre for Applied Health Research, Liverpool School of Tropical Medicine, L3 5PQ Liverpool and Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Mentzakis
authors.affiliation: Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Perth, WA, Australia & School of Economics, University of Bologna, Bologna, Italy, Economics Department, University of Southampton, Southampton, UK, Independent Consultant and Centre for Applied Health Research, Liverpool School of Tropical Medicine, L3 5PQ Liverpool and Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
authors.forename: Thierry
authors.initials: T
authors.lastname: Defechereux
authors.affiliation: Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Perth, WA, Australia & School of Economics, University of Bologna, Bologna, Italy, Economics Department, University of Southampton, Southampton, UK, Independent Consultant and Centre for Applied Health Research, Liverpool School of Tropical Medicine, L3 5PQ Liverpool and Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
authors.forename: Louis W
authors.initials: LW
authors.lastname: Niessen
mesh_terms: D002681:China; D003362:Cost-Benefit Analysis; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration*; D006291:Health Policy / Q000191:economics*; D011050:Policy Making
keywords: Decision making; discrete choice experiment; efficiency; equity