Politicians' and hospital managers' trade-offs in the choice of reimbursement scheme: a discrete choice experiment

Trade-offs in the choice of hospital reimbursement schemes are widely discussed in the health economics literature but no one has previously, to this authors' knowledge, made an attempt at quantifying how purchasers and providers trade-off anticipated outcomes of reimbursement schemes. The purpose of this study is to elicit Danish county council politicians' and hospital managers' preferences for the anticipated incentives and consequences embedded in reimbursement schemes using the discrete choice method. Results indicate that politicians and hospital managers agree that increasing the number of patients treated is the most important objective for the choice of reimbursement scheme. The second most important objective to the politicians is to provide budget safety whereas inducing increased quality of treatment is third. Hospital managers rank inducement of increased quality of treatment as the second most important objective and have the county's budget safety as their third most important objective. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.