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Caring externalities in health economic evaluation: How are they related to severity of illness?
Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Arts and Sciences.
Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Department of Health and Society, Tema Health and Society.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
2005 (English)In: Health Policy, ISSN 0168-8510, Vol. 73, no 2, 172-182 p.Article in journal (Refereed) Published
Abstract [en]

In health economic evaluations, altruistic preferences in the form of caring externalities, i.e. that people care about others' health, is usually not taken into account. In this study we examined how people value their own and others' health. This pilot study was carried out by letting people answer willingness to pay (WTP) questionnaires where internal WTP (own health) and altruistic WTP (others' health) were isolated and examined. A common method used in health economic evaluations is cost-utility analysis, which is based on the maximisation of QALYs. QALY maximisation may be appropriate if altruistic preferences are non-existent or if they are linear in relation to internal preferences (QALYs gained). We found evidence for the existence of altruistic preferences and that these preferences were relatively higher for severe health states (and lower for mild states of health) compared to internal preferences, i.e. when severity of illness increased, the relative increase in caring was higher concerning others than oneself. The difference was statistically significant (P < 0.001). Our results indicate that more attention and resources should be directed to severe health states, as compared to mild health states, than advocated by internal preferences in order to obtain more efficient resource allocation in the health care sector. © 2004 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
2005. Vol. 73, no 2, 172-182 p.
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Social Sciences
Identifiers
URN: urn:nbn:se:liu:diva-31636DOI: 10.1016/j.healthpol.2004.11.008Local ID: 17443OAI: oai:DiVA.org:liu-31636DiVA: diva2:252459
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2011-01-11

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Jacobsson, FredricCarstensen, JohnBorgquist, Lars

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Department of Department of Health and SocietyFaculty of Arts and SciencesTema Health and SocietyFaculty of Health SciencesGeneral PracticeUnit of Research and Development in Local Health Care, County of Östergötland
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