Elicitation of Ostomy Pouch Preferences: A Discrete-Choice Experiment

Background: Previous studies about patients who have undergone ostomy surgery commonly address the issues of the surgery, complications, preoperative counseling, quality of life, and psychosocial changes following surgery. Only a limited number of studies deal with how technical improvements in stoma care would affect patients and, to the author’s knowledge, the present study is the first to elicit preferences for potential improvements in ostomy pouches in the form of monetary values. Objective: This article examines and measures Swedish patients’ preferences for potential improvements in ostomy pouch attributes. The theory, study design, elicitation procedure, and resulting preference structure of the sample is described. Methods: A discrete-choice experiment (DCE) was used to elicit preferences. Respondents were asked to choose between alternatives in choice sets, in which each alternative comprised a number of attributes relating to the adhesive, filter, and flexibility of ostomy pouches. The choices between alternatives made by the respondent imply a trade-off between the attributes and allow for the estimation of individuals’ willingness to pay (WTP) for the attributes of ostomy pouches when cost is included as an attribute. A total of 254 patients responded to the survey and preferences were estimated using a random parameter logit econometric specification. Results: Respondents had significantly positive WTP for all potential attribute improvements presented in the survey, with the strongest preference for reducing the number of leakages; flexibility of the system weighted second, and filter lifetime was the least important. Conclusion: The results confirm that the potential attribute improvements presented to the respondents in this study significantly and positively affect the utility that patients would obtain from a potential improvement in their ostomy pouch. This provides information as to how treatment options in terms of stoma management can be structured so as to maximize the benefits for patients.