doctoral thesis
Improvement of the public health care preventive programs through stated preference valuation

Nikolina Dukić Samaržija (2014)
Sveučilište u Rijeci
Ekonomski fakultet
Metadata
TitleVrednovanje izrečenih preferencija u funkciji poboljšanja preventivnih programa javne zdravstvene zaštite
AuthorNikolina Dukić Samaržija
Mentor(s)Ljerka Cerović
Abstract
Temeljna svrha doktorske disertacije je objediniti i produbiti spoznaje o važnosti uključivanja izrečenih preferencija i povezanih odabira pojedinaca u proces osmišljavanja, prilagodbe i provedbe preventivnih programa javne zdravstvene zaštite. Slijedom toga, osnovni cilj empirijskog djela ovog istraživanja je, korištenjem ekonomske teorije u svrhu mjerenja i vrednovanja izrečenih preferencija ciljne populacije, utvrditi metodološku i aplikativnu (utvrđivanje relevantnih čimbenika na strani potražnje za zdravstvenim uslugama) važnost i potrebitost vrednovanja izrečenih preferencija prilikom osmišljavanja, provedbe i evaluacije preventivnih programa javne zdravstvene zaštite, kroz uporabu i usporedbu različitih metoda vrednovanja izrečenih preferencija.Iz navedenih razloga ispitivale su se preferencije žena iz ciljne populacije Nacionalnog programa ranog otkrivanja raka vrata maternice na području Primorsko-goranske županije te utjecaj pojedinih obilježja programa na razinu njihove korisnosti i formiranje odluka o odazivu na screening, koristeći tri različite metode vrednovanje izrečenih preferencija. Istraživanjem je dokazano (koristeći metodu uvjetovanog ocjenjivanja) kako su različita obilježja Nacionalnog program ranog otkrivanja raka maternice povezana s razinom korisnosti ispitanika. Nadalje, koristeći eksperiment diskretnog odabira (DCE), utvrđeno je da su razine obilježja Programa povezane s odlukama žena o odazivu na screening, dok je metodom najboljeg i najgoreg odabira (BWS), osim promjene u razinama korisnosti unutar pojedinog obilježja (vrijednost skale), utvrđena i razina korisnosti između različitih obilježja Programa, odnosno relativni utjecaj pojedinih obilježja na korisnost ispitanika. Također, istraživanjem je dokazana i mogućnost usporedbe graničnih korisnosti različitih obilježja prema homogenim grupacijama ispitanika te je osim za ciljnu populaciju, kroz prošireni ekonometrijski model, moguće dobiti uvid u kompromise (zamjenu jednog obilježja programa drugim) koji su pripadnici određenih skupina spremni učiniti. Sukladno dobivenim rezultatima istraživanja, može se zaključiti da je potvrđena temeljna hipoteza rada prema kojoj je uvažavanjem preferencija pojedinaca u osmišljavanju i realizaciji zdravstvenih usluga, moguće povećati usvojenost programa od strane pacijenata, odnosno unaprijediti efektivnost javno zdravstvenih preventivnih programa, posljedično i efikasnost sustava javne zdravstvene zaštite. Upravo metode diskretnog odabira (DCE i BWS) pokazale iii su se teorijski opravdane i metodološki primjenjive za vrednovanje preferencija pacijenata, određenih interesnih skupina kao i šire populacije.
Keywordsstated preferences health prevention discrete choice methods effectiveness
Parallel title (English)Improvement of the public health care preventive programs through stated preference valuation
Committee MembersMaks Tajnikar (committee chairperson)
Nenad Smokrović (committee member)
Ljerka Cerović (committee member)
GranterSveučilište u Rijeci
Ekonomski fakultet
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineSOCIAL SCIENCES
Economics
Microeconomics
UDK330
SOCIAL SCIENCES
Economics. Economic science
614
APPLIED SCIENCES. MEDICINE. TECHNOLOGY
Public health and hygiene. Accident prevention
Study programme typeuniversity
Study levelpostgraduate
Study programmeEconomics and Business Economics
Academic title abbreviationdr.sc.
Genredoctoral thesis
Language Croatian
Defense date2014-11-19
Parallel abstract (English)
The purpose of this doctoral thesis is to consolidate and broaden the cognitions on the importance of including stated preferences and related individual choices in designing, adjusting and implementing public health care preventive interventions. Subsequently, the main objective of the empirical investigation was to, based on economic theory, measure and evaluate stated preferences of the target population by using different stated preference valuation methods, in order to identify methodological and applicative relevance of stated preferences valuation in enhancing the effectiveness, and thus the efficiency of public Health care preventive programs.For the above reasons, the analysis of preferences stated by the women in National Program for Early Detection of Cervical Cancer in Primorsko-goranska County, and the impact of individual program attributes on their utility level and decision to attend screening, was conducted using tree different stated preference methods. The research results achieved by the conditional rating method have proven that different National Program attributes are correlated with the utility level of the respondents. Furthermore, the discrete choice experiment (DCE) results indicate that different attribute levels impact women’s decisions to attend screening. In addition to determining the changes in the utility levels within individual attributes (i.e. scale value), the best-worst scaling method (BWS) allowed for determining the level of utility between observed National Program attributes i.e. the relative impact of individual attributes on respondents’ utility. Moreover, the research has confirmed the possibility of comparing marginal utilities of different attributes according to homogeneous groups of respondents, and thus, through the expanded econometric model, allowed insights into compromises (trading one program attribute for another) that the members of certain groups are willing to make. In accordance with the research results, it can be concluded that the basic hypothesis is confirmed i.e. that by taking into account preferences stated by the target population in the process of the design and realization of health care services, it is possible to increase the attendance rate and improve the effectiveness of the public health preventive programs, and consequently, a more efficient public health care system. It were the methods of discrete choice (DCE and BWS) that proved to be theoretically justified and methodologically v applicable for the valuation of preferences stated by the specific target population, as well as he broader population.
Parallel keywords (Croatian)izrečene preferencije zdravstvena prevencija metode diskretnog odabira efektivnost
Versionaccepted version
Resource typetext
Access conditionOpen access
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
Noteaccepted version
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:192:296432
CommitterVesna Knez