The Contingent Valuation Method in Health Care

In the future, as our society becomes older and older, an increasing number of people will be confronted with Alzheimer's disease. Some will suffer from the illness themselves, others will see parents, relatives, their spouse or a close friend afflicted by it. Even now, the psychological and financial burden caused by Alzheimer's disease is substantial, most of it borne by the patient and her family. Improving the situation for the patients and their caregivers presents a challenge for societies and decision makers. Our work contributes to improving the in decision making situation con­ cerning Alzheimer's disease. At a fundamental level, it addresses methodo­ logical aspects of the contingent valuation method and gives a holistic view of applying the contingent valuation method for use in policy. We show all stages of a contingent valuation study beginning with the design, the choice of elicitation techniques and estimation methods for willingness-to-pay, the use of the results in a cost-benefit analysis, and finally, the policy implica­ tions resulting from our findings. We do this by evaluating three possible programs dealing with Alzheimer's disease. The intended audience of this book are health economists interested in methodological problems of contin­ gent valuation studies, people involved in health care decision making, plan­ ning, and priority setting, as well as people interested in Alzheimer's disease. We would like to thank the many people and institutions who have pro­ vided their help with this project.

Contenu

Preface.- List of Abbreviations.- 1 : Introduction.- 1. The contingent valuation method.- 2. Alzheimer's disease.- 3. Study objectives.- 4. Organization of the book.- 2: Study Design.- 1. Economic burden of Alzheimer's disease.- 2. Program 'care' - helping caregivers.- 3. Program 'diagnosis' - detecting AD early.- 4. Program 'research' - search for a cure of AD.- 5. Financing of the programs.- 3 : Elicitation Methods.- 1. Continuous contingent valuation format.- 2. Discrete contingent valuation format.- 3. Biases in contingent valuation studies 17 3.1 Yea-saying.- 3.2 Protest answers.- 3.3 Question ordering bias.- 3.4 Payment vehicle bias.- 3.5 Embedding effect.- 3.6 Warm glow effect.- 3.7 Information bias 20.- 4. Chosen elicitation techniques.- 4.1 Dichotomous choice (DC) format.- 4.2 Dissonance-minimizing (DM) format.- 4.3 Payment card (PC) format.- 4: Estimation Methods.- 1. Estimation methods for the discrete CV (DC and DM).- 1.1 Logistic regression analysis.- 1.2 Nonparametric method.- 2. Estimation methods for payment card (PC).- 5: Data.- 1. Sample structure and data collection.- 2. Descriptive statistics.- 6: Results.- 1. Program 'care' with taxes.- 1.1 Data.- 1.2 Dichotomous choice (DC) format.- 1.3 Dissonance minimizing (DM) format.- 1.4 Payment card (PC) format.- 1.5 Overview of the tax financed care program.- 2. Program 'diagnosis'.- 2.1 Data.- 2.2 Dichotomous choice (DC) format.- 2.3 Dissonance minimizing (DM) format.- 2.4 Payment card (PC) format.- 2.5 Overview of insurance financed diagnosis program.- 3. Program 'research'.- 3.1 Data.- 3.2 Dichotomous choice (DC) format.- 3.3 Dissonance minimizing (DM) format.- 3.4 Payment card (PC) format.- 3.5 Overview of the research program.- 7: Possible Reasons for Variation in the WTP values.- 1. Mean versus median WTP.- 2. Yea-saying and protest answers.- 3. Question ordering.- 4. Payment vehicle.- 5. Representation of the valuation function.- 6. Warm glow effect.- 7. Information bias.- 8: Cost-benefit analysis.- 1. Cost-benefit analysis for the program 'care'.- 2. Cost-benefit analysis for the program 'diagnosis'.- 3. Cost-benefit analysis for the program 'research'.- 4. Policy implications.- 9: Conclusions.- 1. Summary.- 2. Guideline for a contingent valuation study.- 10 : Appendix.- 1. Correlation matrix.- 2. Detail diagnosis.- 3. Detail Research.- 4. Detail care with insurance.- 5. Questionnaires.- 5.1 Questionnaire for programs 'diagnosis' and 'care' with taxes (DC method), full version.- 5.2 Questionnaire for programs 'diagnosis' and 'care' with taxes (DM method), short version.- 5.3 Questionnaire for programs 'research' and 'care' with insurance (PC method), short version.- Acknowledgments.- References.