Valuing informal carers’ quality of life using best‑worst scaling—Finnish preference weights for the Adult Social Care Outcomes Toolkit for carers (ASCOT‑Carer)

This study developed Finnish preference weights for the seven-attribute Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer) and investigated survey fatigue and learning in best-worst scaling (BWS) experiments. An online survey that included a BWS experiment using the ASCOT-Carer was completed by a sample from the general population in Finland. A block of eight BWS profles describing diferent states from the ASCOT-Carer were randomly assigned to each respondent, who consecutively made four choices (best, worst, second best and second worst) per profle. The analysis panel data had 32,160 choices made by 1005 respondents. A scale multinomial logit (S-MNL) model was used to estimate preference weights for 28 ASCOT-Carer attribute levels. Fatigue and learning efects were examined as scale heterogeneity. Several specifcations of the generalised MNL model were employed to ensure the stability of the preference estimates. The most and least-valued states were the top and bottom levels of the control over daily life attribute. The preference weights were not on a cardinal scale. We observed the position efect of the attributes on preferences associated with the best or second best choices. A learning efect was found. The established preference weights can be used in evaluations of the efects of long-term care services and interventions on the quality of life of service users and caregivers. The learning efect implies a need to develop study designs that ensure equal consideration to all profles (choice tasks) in a sequential choice experiment.