Applying conjoint analysis in economic evaluations: an application to menorrhagia

The increased demand for health care, coupled with limited resources, means that decisions have to be made concerning the allocation of scarce health care resources. This paper considers how conjoint analysis (CA) can be used to aid this decision making process. It is shown how the technique can be used to estimate marginal rates of substitution between attributes, willingness to pay (WTP) if cost is included as an attribute and overall utility scores for different ways of providing a service. The technique is applied to consider women's preferences for two surgical procedures in the treatment of menorrhagia: hysterectomy and conservative surgery. The results suggest conservative surgery is preferred to hysterectomy, as indicated by higher utility scores for the former and a marginal WTP of 7593 to have conservative surgery rather than hysterectomy. The internal validity of CA was also shown. It is concluded that CA is a potentially useful instrument for policy makers. However, numerous methodological issues need addressing before the technique becomes an established instrument within economic evaluations.