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Equity and efficiency preferences of health policy makers in China—a stated preference analysis

Paolucci, Francesco, Mentzakis, Emmanouil, Defechereux, Thierry and Niessen, Louis ORCID: (2014) 'Equity and efficiency preferences of health policy makers in China—a stated preference analysis'. Health Policy and Planning, Vol 30, Issue 8, pp. 1059-1066.

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Macroeconomic growth in China enables significant progress in health care and public health. It faces difficult choices regarding access, quality and affordability, while dealing with the increasing burden of chronic diseases. Policymakers are pressured to make complex decisions while implementing health strategies. This study shows how this process could be structured and reports the specific equity and efficiency preferences among Chinese policymakers.

In total, 78 regional, provincial and national level policymakers with considerable experience participated in a discrete choice experiment, weighting the relative importance of six policy attributes describing equity and efficiency. Results from a conditional logistic model are presented for the six criteria, measuring the associated weights. Observed and unobserved heterogeneities were incorporated and tested in the model. Findings are used to give an example of ranking health interventions in relation to the present disease burden in China.

In general, respondents showed strong preference for efficiency criteria i.e. total beneficiaries and cost-effectiveness as the most important attributes in decision making over equity criteria. Hence, priority interventions would be those conditions that are most prevalent in the country and cost least per health gain.

Although efficiency criteria override equity ones, major health threats in China would be targeted. Multicriteria decision analysis makes explicit important trade-offs between efficiency and equity, leading to explicit, transparent and rational policy making.

Item Type: Article
Subjects: WA Public Health > WA 20.5 Research (General)
WA Public Health > Health Administration and Organization > WA 525 General works
WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
Depositing User: Jessica Jones
Date Deposited: 05 Feb 2016 16:09
Last Modified: 30 Aug 2019 17:25


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