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The Demand for Health and the Contingent Valuation Method

Liljas, Bengt LU (1997) In Lund Economic Studies 66.
Abstract
The theoretical part develops Michael Grossman’s dynamic demand-for-health model by (a) letting the depreciation rate depend upon the level of health, (b) allowing a continuous set of health states, (c) introducing uncertainty (by letting health be a stochastic variable), (d) introducing social and private insurance and (e) releasing the assumption of an isoperimetric budget constraint. Beside the theoretical results, there are also results with important policy implications. When conducting empirical willingness-to-pay (WTP) studies, one must acknowledge whether the individual regards the hypothetical scenario as uncertain or not and whether insurance exists for the relevant good.



The empirical part first investigates... (More)
The theoretical part develops Michael Grossman’s dynamic demand-for-health model by (a) letting the depreciation rate depend upon the level of health, (b) allowing a continuous set of health states, (c) introducing uncertainty (by letting health be a stochastic variable), (d) introducing social and private insurance and (e) releasing the assumption of an isoperimetric budget constraint. Beside the theoretical results, there are also results with important policy implications. When conducting empirical willingness-to-pay (WTP) studies, one must acknowledge whether the individual regards the hypothetical scenario as uncertain or not and whether insurance exists for the relevant good.



The empirical part first investigates whether it is possible to apply the contingent valuation (CV) method to operation queues and waiting lists. Due to the exploratory nature and to the poor significance of the statistical model, the results are tentative at most. The dichotomous-choice (DC) WTP questions worked better than the open-ended questions and choosing the bid-vector and not having a too small population are important issues. The impact of ‘objective’ risk information on patients’ WTP for autologous blood donation (ABD) was then estimated. This information reduced the variance and magnitude of the WTP, which showed that the patients initially overestimated the risks. The WTP was significantly related to dread, perceived transfusion risk and income, indicating that ABD provides substantial benefits in the form of ‘peace of mind’.



The experimental part presents the results of two experiments comparing the DC CV approach with ‘real’ purchase decisions for a consumer good. In addition, the hypothesis that a more conservative interpretation of the DC CV approach (where only absolutely sure yes-responses are counted as yes-responses) correctly predicted real purchase decisions was tested. Both experiments showed that the hypothetical yes-responses overestimated the real yes-responses. In the first experiment, the hypothetical absolutely sure yes-responses underestimated the real yes-responses, but in the second experiment the null hypothesis that the conservative DC CV approach corresponded to the real yes-responses could not be rejected. This suggests that it may be possible to sort out the real yes-responses from the false yes-responses by adding a question about the certainty of the yes-response. (Less)
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author
supervisor
opponent
  • Dr Cairns, John, University of Aberdeen
organization
publishing date
type
Thesis
publication status
published
subject
keywords
econometrics, Economics, Willingness to Pay, Contingent Valuation, Cost-Benefit Analysis, Economic Evaluation, Risk perception, Insurance, Grossman model, Uncertainty, Demand for Health, Health Economics, economic theory, economic systems, economic policy, Nationalekonomi, ekonometri, ekonomisk teori, ekonomiska system, ekonomisk politik
in
Lund Economic Studies
volume
66
pages
207 pages
publisher
Bengt Liljas, Astra Draco AB, P.O. Box 34, 221 00 Lund, Sweden,
defense location
Crafoordsalen, Holger Crafoords Ekonomicentrum
defense date
1997-05-22 10:00:00
external identifiers
  • other:ISRN LUSADG/SANA--97/1048--SE
ISSN
0460-0029
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Lund University Centre for Health Economics (LUCHE) (016630120), Department of Economics (012008000)
id
a1790f19-5044-4e11-afc2-c8a22a4092a3 (old id 29220)
date added to LUP
2016-04-01 17:15:59
date last changed
2019-05-21 16:16:21
@phdthesis{a1790f19-5044-4e11-afc2-c8a22a4092a3,
  abstract     = {{The theoretical part develops Michael Grossman’s dynamic demand-for-health model by (a) letting the depreciation rate depend upon the level of health, (b) allowing a continuous set of health states, (c) introducing uncertainty (by letting health be a stochastic variable), (d) introducing social and private insurance and (e) releasing the assumption of an isoperimetric budget constraint. Beside the theoretical results, there are also results with important policy implications. When conducting empirical willingness-to-pay (WTP) studies, one must acknowledge whether the individual regards the hypothetical scenario as uncertain or not and whether insurance exists for the relevant good.<br/><br>
<br/><br>
The empirical part first investigates whether it is possible to apply the contingent valuation (CV) method to operation queues and waiting lists. Due to the exploratory nature and to the poor significance of the statistical model, the results are tentative at most. The dichotomous-choice (DC) WTP questions worked better than the open-ended questions and choosing the bid-vector and not having a too small population are important issues. The impact of ‘objective’ risk information on patients’ WTP for autologous blood donation (ABD) was then estimated. This information reduced the variance and magnitude of the WTP, which showed that the patients initially overestimated the risks. The WTP was significantly related to dread, perceived transfusion risk and income, indicating that ABD provides substantial benefits in the form of ‘peace of mind’.<br/><br>
<br/><br>
The experimental part presents the results of two experiments comparing the DC CV approach with ‘real’ purchase decisions for a consumer good. In addition, the hypothesis that a more conservative interpretation of the DC CV approach (where only absolutely sure yes-responses are counted as yes-responses) correctly predicted real purchase decisions was tested. Both experiments showed that the hypothetical yes-responses overestimated the real yes-responses. In the first experiment, the hypothetical absolutely sure yes-responses underestimated the real yes-responses, but in the second experiment the null hypothesis that the conservative DC CV approach corresponded to the real yes-responses could not be rejected. This suggests that it may be possible to sort out the real yes-responses from the false yes-responses by adding a question about the certainty of the yes-response.}},
  author       = {{Liljas, Bengt}},
  issn         = {{0460-0029}},
  keywords     = {{econometrics; Economics; Willingness to Pay; Contingent Valuation; Cost-Benefit Analysis; Economic Evaluation; Risk perception; Insurance; Grossman model; Uncertainty; Demand for Health; Health Economics; economic theory; economic systems; economic policy; Nationalekonomi; ekonometri; ekonomisk teori; ekonomiska system; ekonomisk politik}},
  language     = {{eng}},
  publisher    = {{Bengt Liljas, Astra Draco AB, P.O. Box 34, 221 00 Lund, Sweden,}},
  school       = {{Lund University}},
  series       = {{Lund Economic Studies}},
  title        = {{The Demand for Health and the Contingent Valuation Method}},
  volume       = {{66}},
  year         = {{1997}},
}