Eliciting healthcare users' preferences for home care versus hospital care in cancer : development of a decision aid integrating a contingent valuation survey.

Summary In France, cancer treatment is mainly dominated by hospital technical platforms, but these are saturated and considered too expensive. For these reasons, public decision-makers wish to develop alternative structures: hospitalization at home or proximity structures (SP) such as multidisciplinary health centres. Objective:-To study the adequacy between public health policies and the preferences of patients and the general population.-To test the acceptability and validity of the contingent valuation (CV) method (willingness-to-pay survey: DTP) as a means of obtaining preferences in the general population in order to guide public decision making.Method:-We developed a computerized information and decision support tool that contained 1. Information on the three care options: hospital, home, SP 2. A preference measurement survey 3. Results: The patient survey was conducted in 3 institutions (n=386), the general population survey was conducted on a representative sample of the Rhône-Alpes Region (n=1001). The hospital was the preferred option for both populations, with 71% of patients versus 42.6% of the general population, followed by the home with 24% of patients and 38.8% of the general population. The acceptability and validity of the CE in the general population seems to be confirmed by the low number of protesters and outliers as well as the correlation between PAD, income and preferences.