Benefits beyond health in the willingness to pay for a quality-adjusted life-year.

Adopting a societal perspective in cost-effectiveness analysis (CEA) requires including all societal costs and benefits even if they fall outside of the realm of health and healthcare. While some benefits are not explicitly included, they might be implicitly included when people value quality-adjusted life-years (QALYs) in monetary terms. An example is utility of consumption (UoC) which has played a crucial role in discussions regarding the welfare economic underpinnings of CEA. This study investigates whether people consider elements beyond health when valuing QALYs monetarily and the influence of inclusion on this value. A Willingness to Pay (WTP) experiment was administered among the general public in which people were asked to assign monetary values to QALYs. Our results show that (stated) UoC increases with quality of life but that instructing people to consider UoC does not impact their monetary valuation of the QALY. Furthermore, many respondents consider elements beyond health when valuing QALYs but the impact on the monetary value of a QALY is limited. These findings suggest that these elements are currently not (adequately) captured in CEA. Findings also illustrate that it is difficult to isolate health from non-health benefits and to consistently capture these in CEA. With that, reconciling CEA with welfare economics remains challenging.

A discrete choice experiment to understand preferences of patients with type 2 diabetes about the attributes of GLP1 receptor agonists in Spain.

OBJECTIVE: To determine the preferences regarding injection, medication frequency and complexity of GLP1 receptor agonists among patients with type 2 diabetes, treatment-naïve for such drugs in Spain. Additionally, patients' willingness to pay according to these attributes was evaluated. METHODS: A discrete-choice experiment survey designed to evaluate patients' preferences over three attributes discriminating by age, sex and patients experience with previous injectable treatment was fulfilled by patients. The resulting model was analyzed using a conditional (fixed-effects) logistic regression. RESULTS: A total of 180 patients (63.35 ± 11.49 years, 63.28% men, 48.41% with previous cardiovascular disease, 54.69% with a time of evolution of diabetes >10 years) recruited from 5 health care centers in Spain completed the survey. Patients viewed positively weekly injections (vs daily injections), but rated negatively a complex preparation of the dose (vs simple preparation). Whereas naïve patients for injectable medications did not consider administration timing of importance, no naïve patients considered it relevant. No relevant differences were observed according to age or gender. Patients were willing to pay 83.25€for a "no preparation required" dose. No naïve and naïve patients were willing to pay 34.61€ and 14.35€; p = 0.000, to change daily injection for a weekly injection. CONCLUSIONS: Patients highly valued the avoidance of injections, with weekly dosing clearly preferred over daily dosing, as well as reducing the treatment complexity. These findings may provide a better understanding of what patients prefer and value in their treatment and provide guidance for clinicians making therapeutic decisions regarding treatments of patients with type 2 diabetes.

Deciphering the neural responses to a naturalistic persuasive message.

Effective health promotion may benefit from understanding how persuasion emerges. While earlier research has identified brain regions implicated in persuasion, these studies often relied on event-related analyses and frequently simplified persuasive communications. The present study investigates the neural basis of valuation change induced by a persuasive healthy eating call, employing naturalistic stimuli. Fifty healthy participants performed two blocks of a bidding task, in which they had to bid on sugar-containing, sugar-free, and nonedible products during functional MRI. In between the two blocks, they listened to a persuasive healthy eating call that influenced their bidding behavior. Intriguingly, participants who resisted persuasion exhibited increased synchronization of brain activity during listening in several regions, including default mode network structures. Additionally, intersubject functional connectivity among these brain regions was found to be weaker in persuaded individuals. These results emphasize the individualized nature of processing persuasive messages, challenging conventional interpretations of synchronized neural activity. Our findings support the emerging practice of tailoring persuasive messages in health promotion campaigns.

Differences in willingness to pay for various types of carbon-labeled products: A dynamic perspective.

Carbon labeling (CL) is a carbon reduction policy with development potential that has not yet been widely promoted worldwide. This study explores the trend of consumers' willingness to pay (WTP) for different types of carbon-labeled products from a dynamic perspective, to provide a reference for future pilot projects. The research team collected 3788 valid questionnaires from China's first-tier cities spanning a five-year period and used interval regression to analyze the impact and change of consumer traits on WTP for the four types of carbon-labeled products in 2019 and 2024. The bootstrap method was further used to examine the impact mechanisms to explore ways to improve the current situation. This study found that (1) WTP for food, textiles, electronics, and other household products with CL generally decreased from 2019 to 2024. Textiles and electronics experienced a smaller decline, while food and other household products witnessed larger decreases. (2) The effect of consumer characteristics on WTP changes from 2019 to 2024. Consumers' frequency of low-carbon behaviors no longer significantly affects WTP across all product categories, while attitudes toward CL only affect textiles and electronics. (3) Consumers' perceived environmental value is the mechanism by which personal traits affect WTP. Finally, based on the findings, this study suggests that the selection of textiles and electronics as a pilot product is more likely to be accepted by consumers and that emphasis should be placed on the promotion of the environmental values of CL.

Assessing the impact of farmers' willingness to pay on different cultivated land attribute levels in China: an empirical analysis using the choice experiment method.

Exploring farmers' willingness to pay (WTP) for cultivated land protection and its influencing factors is key to promoting their enthusiasm for participating in cultivated land pollution governance. However, existing studies often overlook the differences in farmers' preference for different levels of cultivated land attributes and the issue of intertemporal choice in farmers' WTP, thus lowering the effectiveness of cultivated land protection policies. Using survey data from 646 small farmers in Shandong, Jiangsu, and Zhejiang provinces of China, this study empirically analyzes the impact of time preference on farmers' WTP for cultivated land attribute levels by utilizing the choice experiment method, measures the relative importance of different cultivated land attributes and attribute levels to farmers, and calculates farmers' WTP for different cultivated land attribute levels. The results revealed that farmers are generally reluctant to pay for cultivated land protection. Time preference affects farmers' WTP for different levels of cultivated land attributes, with future-biased preference increasing farmers' WTP and present-biased preference inhibiting it. Furthermore, for farmers, the relative importance of cultivated land attributes is in the order of cultivated land quality, cultivated land surrounding landscape and ecological environment, cultivated land social security function, and cultivated land area. The most crucial cultivated land attribute level is the improved cultivated land quality, with an average WTP of 3290.625 CNY per hectare (approximately 459.117 USD). In contrast, the least important cultivated land attribute level is the unchanged cultivated land area, with an average WTP of 1001.250 CNY per hectare (approximately 139.697 USD). The economic benefits of cultivated land protection in the sampled provinces can reach 353.892 million CNY per year (approximately 49.376 million USD) annually, which is calculated based on vegetable planting area. Our results suggest that the government should diversify farmers' sources of income while increasing the amount of income, thereby reducing barriers to farmers' payment. Simultaneously, farmers' time preferences should be considered to guide them toward expecting long-term benefits and encouraging their active participation in cultivated land pollution governance. Moreover, cultivated land protection policies should match the preference of farmers for cultivated land attributes and attribute levels, and a limited fiscal fund should be allocated to the cultivated land attributes (i.e., cultivated land quality) and attribute levels (i.e., improved cultivated land quality) preferred by farmers to improve policy efficiency. This study highlights the importance of encouraging farmers to actively participate in cultivated land pollution governance and improving the allocation efficiency of the government's cultivated land protection fund.

Assessing determinants and readiness for willingness-to-pay (WTP) for unit-based pay-as-you-throw (PAYT) waste tariff structures: A case study of Kathmandu, Nepal.

Many cities in developing countries are searching for financially motivated behavior-based alternatives, such as pay-as-you-throw (PAYT) tariff mechanisms, over conventional methods. This study explores the determinants and readiness for willingness-to-pay (WTP) for introducing unit-based PAYT tariff structures in Kathmandu, Nepal. Two distinct colored volume-based recyclable plastic bags (1 L and 20 L) waste collection systems were introduced, and their acceptability was assessed using the contingent valuation method (CVM) spike model. The findings from a survey of 401 households revealed that the public shows their willingness to replace existing fixed tariff structures with PAYT systems, with WTP values of NRs 36.1 and NRs 42.14 (USD 0.28 and 0.32) for each 1 L and 20 L bags, respectively. Income, age, sex, family size, and household status were the key determinants. Tenants were more willing to pay than homeowners. The PAYT system has a substantial additional revenue generation of 326 % compared to conventional fixed tariff structures and reduces the financial burden of waste financing for public entities. Innovative PAYT tariff structures are also expected to be an effective tool not only from a revenue generation perspective, but also as a financially motivated behavioral tool for waste segregation, reduction, and recycling for sustainable waste management in developing countries.

Transfusion burden and willingness to pay for temporary alleviation of anemia status in transfusion-dependent beta-thalassemia patients in China.

BACKGROUND: Transfusion-dependent ß-thalassemia (TDT) is one of the global public health concerns highlighted by the World Health Organization. Patients with TDT require regular blood transfusion to survive. However, the availability of blood resources is extremely limited. The purpose of this study was to investigate transfusion burden and willingness to pay (WTP) for temporary remission of anemia status among patients with TDT and to explore the associated factors. METHODS: Adult patients with TDT were recruited through cluster sampling across several high-incidence provinces in China. Consenting patients completed online questionnaires on demographic information, transfusion burden and WTP with real-time WeChat communication assistance from researchers. The guiding techniques of double-bounded dichotomous choices and open-ended questions in the contingent valuation method (CVM) were used to obtain participants' WTP for 1 unit of leukocyte-depleted red blood cells. WTP calculations were performed using maximum likelihood estimation, with further insights gained through subgroup analysis based on gender, family monthly income level and convenience of blood transfusion. RESULTS: The analysis included 149 TDT patients from five high-incidence provinces, with an average monthly income of $198.5. Patients received an average of 3.7 units per transfusion, 15.4 times annually, with an average WTP of $70.4 per unit (95% CI [62.0, 78.9]). Estimated WTP for temporary anemia alleviation per transfusion totaled $260.6, exceeding monthly income by 1.32 times. Higher WTP was observed among males, higher-income households, and those with at least junior education. Lower WTP was noted among patients with lower transfusion volumes and those needing to travel for transfusion or during hospitalization for blood transfusion. CONCLUSION: High WTP indicated a strong desire for temporary anemia relief. Most TDT patients faced significant economic and transfusion burden. The evident gap in meeting clinical needed underscores the urgent demand for innovative treatments to reduce transfusion dependency, potentially transforming TDT care and improving socioeconomic well-being and clinical outcomes. These findings supported evidence-based decision-making for TDT pharmacoeconomics and efficient healthcare resource allocation in China.

A systematic review of economic evaluations of orphan medicines for the management of spinal muscular atrophy.

Spinal muscular atrophy (SMA) is a rare inherited autosomal recessive progressive disease of a varying phenotype, with varying clinical symptoms, and as a result the patients suffering from it require multiple types of care. It was deemed useful to conduct a systematic literature review on the pharmacoeconomic evaluations of all currently registered disease-modifying therapies in order to inform policy and highlight research gaps. Pharmacoeconomic analyses written in English and published after 2016 were considered for inclusion. PubMed/Medline, Global Health and Embase were systematically and separately searched between 16 October and 23 October 2023. Hand-searching was also conducted on PubMed based on reference lists of published literature. After the exclusion criteria were applied, 14 studies were included. BMJ checklist was used for quality assessment and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to assess the quality of reporting of all included studies. Data extraction was performed manually. Regarding evidence synthesis, data were heterogeneous and are thus presented based on comparison. This study confirms the need for pharmacoeconomic analyses (cost-effectiveness or cost-utility) also in cases when the cost of treatment is very high and the incremental cost-effectiveness ratio values exceed the usual, acceptable values for standard therapy. Specific willingness to pay thresholds for orphan medicines are of the utmost importance, to allow patients with SMA to have access to safe and effective treatments. With such economic evaluations, it is possible to compare the value of medications with the same indication, but it should be emphasized that in the interpretation of data and in making decisions about the use of medicines, the impact of new knowledge should be considered.

Subjective Valuation of Screening for Spinal Muscular Atrophy and Analysis of its Influencing Factors: Evidence from Iran.

Background: Spinal muscular atrophy is an inherited neurodegenerative disorder that typically leads to severe physical disability. The present study aimed to determine the subjective evaluation of this disorder screening and analyze its influencing factors in Iran. Methods: A cross-sectional study was performed using data from the second survey of women either pregnant or planning to become pregnant in Tehran, the capital of Iran, in 2022. The dependent variable was the willingness to pay for this disease screening test. The independent variables included sociodemographic, economic, and health characteristics, the history of this disease or other diseases of the person and family, and knowledge about this disease in the included population. Logistic regression was utilized to identify independent variables associated with the dependent variable, and the results were reported as unadjusted and adjusted odds ratios and P values with 95% CIs. A questionnaire was used as a research tool, and STATA 17 software was used for data analysis. The monetary value of spinal muscular atrophy (SMA) screening was calculated by estimating willingness to pay using the congenital valuation method. Results: In total, 578 women were included. About 64.85% of respondents had a willingness to pay for SMA screening as the dependent variable, with a mean of $526. University education (P = 0.009) and pregnancy experience (P = 0.021) were associated with the dependent variable. Conclusion: Iranian women expressed their willingness to undergo screening tests, but due to financial constraints, they expected the government and nongovernmental organizations to bear most of the cost.

Utilizing Sensory and Visual Data in the Value Estimation of Extra Virgin Olive Oil.

Food evaluation is a topic central to consumer research and food marketing. However, there is little consensus regarding how consumers combine sensory stimuli, product information, and visual impressions to shape their evaluation. Moreover, the bulk of research relies on studies based on questionnaires and declarative responses, raising questions about subliminal processes and their hierarchy in an evaluation process. To address this gap in the literature, we conducted a study with more than 400 participants in Morocco and Tunisia and investigated how factors such as flavor/taste, product information, and packaging design in a variety of olive oils influence visual attention and are reflected in willingness to pay (WTP). We implemented incentivization through an auction to reduce the hypothetical bias in stated WTP values. The results revealed that, compared to tasting the oils, the provision of cognitive information led to an increase in consumers' WTP. However, a drastic increase in WTP occurred when the consumers were exposed to package designs, overshadowing the formerly dominant effects of product attributes. These findings support theories suggesting a visual perceptual processing advantage due to the picture superiority effect-a picture says a thousand words. Further, it underlines the importance of graphic design in food marketing. The findings have ramifications for food marketing, product development, and pricing strategies.

Measuring the harm of sugar sweetened beverages and internalities associated with it.

Introduction: Obesity, which is partly driven by the consumption of sugar-sweetened beverages (SSBs), significantly increases the risk of type-2 diabetes and cardiovascular diseases, leading to substantial health and economic burdens. Methods: This study aims to quantify the monetary value of health harms caused by SSB consumption, along with the associated internalities, through a contingent valuation survey. The results are crucial for determining the socially optimal tax rate. Results: We surveyed 293 residents of Wellington, New Zealand, to assess their willingness to pay (WTP) for reductions in the risks of diabetes, stroke, and heart disease associated with SSB intake. Logistic regression analysis revealed the marginal WTP for a 1% risk reduction in diabetes, stroke, and heart disease to be NZ$404.86, NZ$809.04, and NZ$1,236.84, respectively. Based on these values, we estimate the marginal harm from SSB consumption to be approximately NZ$17.37 per liter in New Zealand, with internalities amounting to NZ$6.43 per liter, suggesting an optimal tax rate of NZ$6.49 per liter. Discussion: Implementing such a tax is feasible and would likely double or triple the price of SSBs in New Zealand.

Consumer Preference and Willingness to Pay for Rice Attributes in China: Results of a Choice Experiment.

Understanding urban consumers' preferences for rice attributes is crucial for rice breeders, producers, and retailers to meet diverse and evolving market demands. Based on the sample data of 629 rice consumers in Shanghai, China, obtained through the choice experiment (CE) approach, this study uses the mixed logit (ML) model to analyze consumers' preferences and willingness to pay (WTP) for food safety labels, brands, nutritional quality, and taste quality. Furthermore, the latent class (LC) model examines the heterogeneity in consumer group preferences. The research findings highlight that consumers prioritize taste quality as the most crucial attribute, followed by nutritional quality, food safety labels, and brand attributes. The premium rates for superior taste quality, organic certification labels, and green certification labels exceeded 100%. Interestingly, while combining organic certification with well-known international or domestic brands does not uniformly boost consumer preferences, incorporating green certification alongside well-known international or domestic brands significantly elevates those preference levels. Factors such as the external environment, consumption habits, and personal characteristics significantly influence individuals' preferences for rice attributes. Based on these insights, the study puts forth policy recommendations for rice breeders, producers, and retailers.

Willingness of West African Consumers to Buy Food Produced Using Black Soldier Fly Larvae and Frass.

The use of black soldier fly (BSF) larvae and frass in agriculture can make an important contribution to food and nutrition security. However, it is important to understand whether consumers are willing to consume food products resulting from the use of BSF larvae as animal feed or BSF frass as fertilizer. This study employed the stated preference approach as food products produced using BSF larvae and frass are not currently available on the market. Questionnaires were administered to a total of 4412 consumers in Ghana (1360), Mali (1603), and Niger (1449). The results show that the vast majority of respondents are willing to consume vegetables (88%) produced using BSF frass and meat (87%) produced using animal feed made of BSF larvae. A smaller percentage of respondents are even willing to pay USD 1.32 and USD 1.7 more if the base price of BSF-based products were USD 5 per kg. Age, gender, education, and country positively influenced the respondents' willingness to consume food produced using BSF products. In contrast, neighborhood status, income, and household size are inversely related to the respondents' willingness to pay for and consume these products. Our findings are, therefore, important to scaling up BSF technologies in the region.

Determinants of maize farmers willingness to pay for private extension services in Ejisu municipality, Ghana.

In recent times, private sector involvement in extension services delivery in Ghana has increased. We assessed farmers' willingness to pay (WTP) for private extension services. We used quantitative techniques and selected 385 farmers through multistage sampling technique. Farmers' had a good perception of private extension services because of its flexibility, availability, value for money, and acceptable rates. Income, secondary occupation, marital status, extension contact, amount of maize sold every season, and land tenure system have an effect on farmers' WTP and the amount to pay. Government policies should continue to encourage and support private sector participation in providing extension services.

Assessing willingness to pay for children's COVID-19 vaccination among healthcare providers and users using a theory-based discrete choice experiment.

Improving vaccine coverage among children is crucial to prevent the long-term consequences of COVID-19 infections and the emergence of resistant COVID-19 variants, especially in resource-scarce settings. This study determined factors influencing the willingness to take and pay for COVID-19 vaccine for children among Vietnamese healthcare professionals and the public. A Theory-Based discrete-choice experiment was focused on a different topic related to vaccines, including the COVID-19 vaccine for children, Monkeypox, the adult COVID-19 booster, the HIV vaccine, and a potential future pandemic. The recruitment period was from April to August 2022, and a total of 5700 Vietnamese individuals aged 16 and above from various regions of the country participated in the study. The data for the sub-study on the COVID-19 vaccination for children was completed by 891 of these participants. Most participants agreed on vaccination for all children. Among healthcare professionals it was 76.2% and 69.3% for the general population. Healthcare professionals were the main source of vaccine information (70.7%). Payment options of 50%, 100%, and full subsidy were the most popular. Concerns about vaccine characteristics were associated with lower acceptance among healthcare professionals and the general public. The burden of historical medical expenses negatively correlated with willingness to pay for vaccination, while service satisfaction positively correlated with willingness to pay. To develop an effective vaccination program among children in Vietnam, providing accurate information and satisfying vaccine services, primarily through knowledgeable and professional healthcare providers, can improve the willingness to vaccinate and pay for the COVID-19 vaccine.

Are all-encompassing better than one-trait sustainable labels? The influence of Eco-Score and organic labels on food perception and willingness to pay.

Front-of-Package (FOP) labels have been used to inform consumers about the nutritional quality, specific attributes, and, more recently, the sustainability impact of food products. For nutritional labels, there is evidence that all-encompassing labels providing a summary score of a product's nutritional quality are effective in influencing consumer behavior, however less is known about the impact of sustainable labels. This research compares an all-encompassing sustainable label summarizing several sustainable product's features into one score, to a one-trait sustainable label focusing on one sustainable attribute. Two controlled online experiments compare an all-encompassing label (i.e., Eco-Score) to a one-trait label (i.e., organic label) and test how their presence influences consumers' willingness to pay. Study 1 (N = 290) shows that a positive all-encompassing sustainable label (Eco-Score B) does not result in a greater willingness to pay for a box of cereal when compared to no label, and to a one-trait sustainable label (organic), even though the Eco-Score incorporates the product's organic attribute in its assessment. Study 2 (N = 577) shows that consumers were willing to pay less for a product featuring an all-encompassing positive Eco-Score label, compared to the same product with an organic label. It also tests a mechanism behind this effect related to the perceived benefits evoked by the label: while the Eco-Score is perceived as only providing environmental benefits, the organic label also provides more concrete health benefits (i.e., it is good for one's health). Implications for public policy are discussed.

Gendered farmer perceptions towards soil nutrition and willingness to pay for a cafetière-style filter system for in-situ soil testing: Evidence from Central Kenya.

Soil nutrition is a key pillar in agricultural productivity. However, point-of-need testing for soil nutrition is not readily available in resource-limited settings such as Kenya. We set out to study the perceived need for soil testing among farmers in this country. A group of 547 farmers from Murang'a and Kiambu counties in central Kenya were recruited through multi-stage sampling to help assess the perceptions and willingness to pay (WTP) toward a prototype technology for surveillance of in-situ soil nutrition. The technology is based on a cafetière-style filter system for extraction and a microfluidic paper-based analytical device (µPAD) for nutrient readout. We employed the double bounded choice contingent valuation method (CVM) to analyze the willingness of farmers to accept and pay for the prototype if the technology was available on the market. It was found that currently, only 1.5 % of farmers carry out soil testing. The high costs of analysis at testing centers, which are often far from the farmers, are among the main reasons contributing to the majority of farmers not testing their soils. The farmers surveyed were generally willing to make their soil data publicly accessible, especially to extension officers. CVM showed that uncontrolled WTP had a 94.24 % premium above KSh1,000 ($6.60) incurred by using the existing rapid testing method. Factoring the control variables and disaggregating the model into gender categories, the findings showed that youth, women, and men had WTP values of KSh1,612.53 ($10.75), KSh1,558.68 ($10.39), and KSh1,504.83 ($10.03), respectively, indicating that farmers can indeed pay for the convenience to test their soils in situ. Through the democratization of soil nutrition data, extension agents can enhance the improvement of agricultural productivity, which implies that farmers can commercialize their agricultural activities.

Athletes preferences and willingness to pay for innovative high-protein functional foods.

The growing number of athletes in the population leads to an increasing demand for high-protein functional foods to which food industries are trying to respond with new products and strategies that can meet the needs of athletes. An experimental auction was performed to elicit athletes' willingness to pay for an innovative high-protein bread, correlating it to specific food values. For a deeper understanding of the determinants of respondents' choices for high-protein bread and preferences regarding food values, the combination of Best-Worst Scaling and Cluster Analysis was used. The Cluster Analysis identified five different groups of athletes, each characterised by specific preferences and willingness to pay. Participants with high attention for the nutritional aspect and needs related to sports activity, are willing to pay more than the other ones. The investigated issue is crucial for customizing marketing strategies and meeting the needs of different athlete segments.

Factors Associated With Willingness to Pay for Primary Health Care Services in South Africa: A Cross-Sectional Survey of Medical Schemes Members.

The cost of healthcare is an issue of concern for both consumers and funders of healthcare in South Africa. The country spends approximately 8% of GDP on health care. Health care is financed through the public sector which covers 86% of the population and the private sector which covers 14% of the population. Medical schemes are the main source of healthcare financing in the private sector. Services covered by medical schemes include chronic diseases, emergencies, diagnosis, and treatment of a selected number of diseases. Primary health care services such as screening are limited. The aim of this study was to assess factors associated with members of medical schemes' willingness to pay for a primary health care package in the private sector. A cross-sectional survey was conducted amongst principal members of medical schemes between July and September 2020. All principal members with access to an online questionnaire were eligible to participate in this study. Logistic regression was used to identify factors associated with willingness to pay for primary health care services. A total of 6512 members of medical schemes participated in the study. Thirty-five percent of the participants were willing to pay for the primary health care package. Factors influencing willingness to pay included marital status, employment status, income and household size. The study highlights the need for policymakers to consider socioeconomic factors when designing health care policies.

Exploring tourists' preferences and willingness to pay for national park recreation improvements based on regret and utility comparison.

Research on the improvement of national park recreation policies has attracted much attention to discrete choice experiments to obtain tourists' preferences and willingness to pay. However, individual choice behavior is extremely complex, and the single Random Utility Maximization (RUM) model ignores anticipated regret and is insufficient to explain individuals' actual choice behavior. To investigate whether regret influences tourists' choices regarding the improvement of national park recreation attributes, this study introduces the Random Regret Minimization (RRM) model and explores the performance of polynomial logit models and hybrid latent class models in analyzing discrete choice models based on utility and regret. By constructing a hybrid utility-regret model, we examine how tourists trade off between attributes such as vegetation coverage, water clarity, amount of litter, and level of crowding in national park recreation. Results indicate that the RRM model has better goodness-of-fit and predictive ability than the RUM model, indicating that regret is a significant choice paradigm, and the hybrid model better explains respondents' choices. Specifically, 62.5% of tourists' choices are driven by regret, and regret-driven respondents are more inclined to increase vegetation coverage and improve water clarity, while utility-driven respondents are more inclined to reduce litter and crowding. This study not only provides a reference for managers to develop more optimal recreation improvement strategies but also offers theoretical insights for national park recreation improvement policies.