Preferences of older patients and choice of treatment location in the UK: A binary choice experiment

Current National Health Service (NHS) policy places importance on allowing patients to choose the time and location of their treatment. However, existing evidence suggests that older people have distinct needs and preferences from those of the general population. This study aimed to elicit preferences over cataract surgery from older people using a stated preference experiment. In order to reduce the cognitive load of the experiment, a binary choice format (accept treatment, reject treatment) was used. Analysis suggests that the strongest determinant of whether or not to accept treatment may be whether or not a consultant performs the operation. In monetary equivalents, a one mile increase in travel and a 1 week increase in waiting time are both valued at approximately £2, whilst consultant-led care is valued at approximately £25. Whilst the majority of our sample ultimately selected the closest treatment location available the results here suggest that older people are able to make trade-offs between pertinent attributes of choice. Here, the closest treatment location may simply be the one that best reflects their preferences.