Identification and Prioritization of Attributes for a Discrete Choice Experiment Using the Nominal Group Technique: Patients' Choice of Public Health Facilities in Cape Town, South Africa

Plaxcedes Chiwire*, Silvia M Evers, Hassan Mahomed, Mickaël Hiligsmann

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


OBJECTIVES: To date, there has been scant research on patient input regarding the desirable characteristics of healthcare facilities. This study uses the nominal group technique (NGT) to develop a discrete choice experiment (DCE) aimed at identifying and prioritizing, from the patient's perspective, essential characteristics for choosing public health facilities in Cape Town, South Africa.

METHODS: Four focus group discussions were conducted, including a total of 21 patients or their parents/companion at Bothasig and Goodwood community day centers (which offer primary care within substructure) in Cape Town. The group discussions followed the steps of NGT guidelines. At each facility, the frequency of an attribute being within the top 5 was determined, a weighted ranking was calibrated, and a subgroup analysis was performed.

RESULTS: The 6 most important attributes in choosing a facility were "treatment by a doctor/(family physician)" (66.7%), "distance to the community day center" (61.7%), "availability of medication" (61.7%), "confidentiality during treatment" (57.7%), and "waiting time" and "treatment by a nurse." The weighted results showed that distance was the most important, followed by treatment by the doctors, treatment confidentiality, availability of medication, and waiting time and treatment by a nurse.

CONCLUSION: This study confirms the feasibility and value of the NGT in identifying and prioritizing the attributes for a DCE. The NGT can be used to elicit patient preferences and, when used together with a DCE, can enhance information quality and quantity for decision making in tandem with patient satisfaction and experiences.

Original languageEnglish
Pages (from-to)90-98
Number of pages9
JournalValue in Health Regional Issues
Publication statusPublished - Jan 2022


  • Health Facilities
  • Humans
  • Patient Preference
  • Patient Satisfaction
  • Primary Health Care
  • South Africa
  • attribute identification
  • CARE
  • facility choice
  • discrete choice experiments
  • patient preferences
  • health provider choice
  • nominal group technique
  • public health facilities

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