The importance of public participation in transport planning continues to increase. Participatory Value Evaluation (PVE) is a relatively new instrument to involve citizens in transport planning. In a PVE, citizens are put into the shoes of a policymaker and see which polices are considered, the impacts of the policies and the constraint that the policymaker faces. Subsequently, citizens are asked to advise the policymaker on which policy options should be chosen and why. So far PVE has been successfully applied in contexts in which citizens and stakeholders broadly agreed on the pursued policy goals. It is, however, unclear whether PVE is equally valuable in contexts in which stakeholders have conflicting interests. This paper investigates whether deploying PVE in an institutionalized transport conflict results in similar benefits and costs as in contexts where stakeholders pursue the same goals. We studied a PVE application in which 2466 participants provided recommendations to the government about decision-making regarding Schiphol Airport, the Netherlands. Stakeholders were involved in many phases of and decisions on the PVE design process. The aim of this research was twofold. First, to establish whether the benefits of applying PVE in an institutionalized transport conflict outweigh the costs. Second, to develop an instrument to assess the face validity of PVE as experienced by participants. We find that PVE can provide similar benefits in the context of an institutionalized conflict compared to cases in which such a conflict was absent. Citizens participated who normally do not participate and the PVE produced useful outcomes for decision-making. However, a notable difference is that the design phase of the PVE involved several feedback rounds which made it much more time-intensive than other cases. Hence, the benefit that PVE requires low time investment of civil servants that emerged in other studies was not applicable when applying PVE to an institutionalized transport conflict setting. Furthermore, stakeholders could not agree on various design choices of the PVE. To satisfy the diverging requests of stakeholders a very lengthy PVE was constructed. As a result, the satisfaction among participants about its face validity was relatively low.

Objective: Increasing healthcare expenditures require governments to make difficult prioritization decisions. Considering public preferences can help raise citizens’ support. Previous research has predominantly elicited preferences for the allocation of public resources towards specific treatments or patient groups and principles for resource allocation. This study contributes by examining public preferences for budget allocation over various healthcare purposes in the Netherlands. Methods: We conducted a Participatory Value Evaluation (PVE) choice experiment in which 1408 respondents were asked to allocate a hypothetical budget over eight healthcare purposes: general practice and other easily accessible healthcare, hospital care, elderly care, disability care, mental healthcare, preventive care by encouragement, preventive care by discouragement, and new and better medicines. A default expenditure was set for each healthcare purpose, based on current expenditures. Respondents could adjust these default expenditures using sliders and were presented with the implications of their adjustments on health and well-being outcomes, the economy, and the healthcare premium. As a constraint, the maximum increase in the mandatory healthcare premium for adult citizens was €600 per year. The data were analysed using descriptive statistics and a Latent Class Cluster Analysis (LCCA). Results: On average, respondents preferred to increase total expenditures on all healthcare purposes, but especially on elderly care, new and better medicines, and mental healthcare. Three preference clusters were identified. The largest cluster preferred modest increases in expenditures, the second a much higher increase of expenditures, and the smallest favouring a substantial reduction of the healthcare premium by decreasing the expenditure on all healthcare purposes. The analyses also demonstrated substantial preference heterogeneity between clusters for budget allocation over different healthcare purposes. Conclusions: The results of this choice experiment show that most citizens in the Netherlands support increasing healthcare expenditures. However, substantial heterogeneity was identified in preferences for healthcare purposes to prioritize. Considering these preferences may increase public support for prioritization decisions.