Using discrete choice modelling in priority setting: an application to clinical service developments

Limited resources for health care means that techniques are required to aid the process of priority setting. This paper represents one of the first at tempts to use discrete choice modelling (DCM) within the area of priority s etting. It is shown how the technique can be used to estimate cost per unit of benefit ratios for competing clinical service developments. Integer pro gramming is proposed as a method to be used, alongside DCM, to help policy makers select the optimal combination of clinical service developments with in a given budget. The technique is also shown to be internally valid and i nternally consistent. It is argued that DCM is a potentially useful techniq ue to be used within the area of priority setting more generally. However, further work is required to address methodological issues around the techni que. (C) 1999 Elsevier Science Ltd. All rights reserved.