Developing a Discrete Choice Experiment Questionnaire to Design Health Policy Interventions for Rural Retention of Specialist Physicians in Rajasthan, India

Abstract

Background: Understanding the preferences of specialist physicians is essential to mitigate their critical deficiency in the Indian rural healthcare system. This necessitates an urgent focus to inform health policy interventions imperative to address and strengthen the vacancies of specialist physicians in the Indian rural healthcare system. The policy interventions should address the preferences of specialists, leading to their intention to stay in rural postings. The paper aims to develop a questionnaire to assess specialist physicians' preferences for rural postings using a discrete choice experiment (DCE).

Materials and methods: A DCE is a widely utilized quantitative approach to understanding health workers' preferences, positing that individuals make trade-offs while selecting an alternative product or service that provides the most utility. This paper comprehensively explains the stages of developing the DCE questionnaire, which involves creating choice sets using various experimental designs to ascertain specialist physicians' preferences for rural postings.

Results: The choice sets for the specified attributes and levels in the study were generated by mathematically combining hypothetical job scenarios using diverse experimental designs. The study employed a pairwise design for the mathematical combination of hypothetical job scenarios, yielding 90 unique choice sets with an equal likelihood of involvement across each of the six blocks. Consequently, each of the six blocks contained 15 distinct choice sets, administered to participants as six DCE questionnaire versions.

Conclusion: This paper outlines the creation of a DCE questionnaire aimed at elucidating the incentive preferences of specialist physicians in rural Rajasthan. It describes the development of diverse experimental designs and the creation of choice sets for the questionnaire's formulation. The objective is to offer a comprehensive guide for novice researchers, doctoral scholars, and health practitioners, imparting information and comprehending the intricacies involved in DCE questionnaire design, even if they are new to this research methodology.

Keywords: choice sets; discrete choice experiment questionnaire; experimental designs; rural healthcare system; specialist physicians.