The use of willingness to pay (WTP) in valuing the benefits of health care programs is increasing. Although such values have been denved using open-ended, bidding, or payment-card techniques, recently discrete-choice questionnaires have been advocated, particularly following the report of the National Oceanographic and Atmospheric Administration concerning the validity of using WTP to estimate environmental benefits. It is argued that discrete-choice questions offer a more realistic market, and will therefore lead to more valid responses and yield higher response rates through reduced mental demands. The author reviews these issues in a critical assessment of discrete-choice questions. Key words: Willingness to pay; cost-benefit analysis; health economics; questionnaire format; methodology. (Med Decis Making 2000;20:194-206)
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References
1.
Johannesson MTheory and methods of economic evaluation of health careDordrecht, The Netherlands Kluwer Academic Publishers, 1996
2.
McFadden D, Leonard GIssues in the contingent valuation of environmental goods: methodologies for data collection and analysis In: Hausman JA (ed) Contingent Valuation A Critical Assessment, Amsterdam, The Netherlands. North Holland , 1995
3.
Jones-Lee MWThe economics of safety and physical riskOxford, UK. Basil Blackwell, 1989
4.
Jones-Lee MWThe value of transport safety. Oxford Review of Economic Policy1990,639-60
5.
Cummings RG, Brookshire DS, Schulze WDValuing Environmental Goods: An Assessment of the Contingent Valuation Method . Totowa, NJ. Rowman and Allanheld , 1986
6.
Diener A, O'Brien B, Gafni A.Health care contingent valuation studies a review and classification of the literatureHealth Econ. 1998,7:313-26
7.
Klose TThe contingent valuation method in health careHealth Policy. 1999 ,47.97-123.
8.
Mitchell R, Carson RUsing Surveys to Value Public Goods. The Contingent Valuation MethodWashington, DCResources for the Future, 1989
9.
Hanemann WMValuing the environment through contingent valuationJ Economic Perspectives . Fall 1994;8(4):19-43
10.
O'Conor RM, Johannesson M, Johansson POStated preferences, real behaviour and anchoring some empirical evidenceEnvironmental and Resource Economics1999 ,13235-48
11.
Hanemann WMSome issues in continuous and discrete response contingent valuation studiesNortheastern J of Agricultural Economics1985,5.5-13.
Alberini A.Testing willingness to pay models of discrete choice contingent valuation data. Land Economics. 1995,71: 83-95
14.
Milon JW.Contingent valuation experiments for strategic behaviourJ Environmental Economics and Management1989;17293-308.
15.
Cameron T, Quiggin J.Estimation using contingent valuation data from a 'dichotomous choice with follow-up' questionnaireJ Environmental Economics and Management1994, 24:218-34.
16.
Langford IH, Bateman IJ, Langford HD.A multilevel modelling approach to triple bounded dichotomous choice contingent valuation. Environmental and Resource Economics.1996;7:197-211.
Carson TR, Hanemann WM, Mitchell RCDetermining the Demand for Public Goods by Simulating Referendums at Different Tax Prices, Department of Economics Working Paper, University of California, San Diego, CA, 1986 .
19.
National Oceanic and Atmospheric Administration.Report of the NOAA panel on contingent valuation. Fed Reg1993,584602-14
20.
Hanemann WMWelfare evaluations in contingent valuation experiments with discrete responses. Am J Agricultural Economics1984,August 332-41
21.
Johannesson MThe contingent valuation controversy in environmental economics and its relevance to health services research. J Health Serv Res Policy1996;1:116-7
22.
Johannesson M, Jonsson B, Karlsson G.Outcome measurement in economic evaluation. Health Econ1996,5279-96
23.
Miedzybrodzka Z, Shackley P, Donaldson C, Abdalla MCounting the benefits of screening a pilot study of willingness to pay for cystic fibrosis carrier screening . J Med Screening1994,1:82-3.
24.
Miedzybrodzka Z, Semper J, Shackley P, Abdalla M, Donaldson C.Stepwise or couple antenatal carrier screening for cystic fibrosis? Women's preferences and willingness to payJ Med Genet.1995,32.282-3.
25.
Johannesson MEconomic evaluation of hypertension treatmentInt J Technol Assess Health Care. 1992;8:506-23
26.
Eckerlund I, Johannesson M, Johansson P-O, Tambour M, Zethraeus N.Value for money? A contingent valuation study of the optimal size of the Swedish health care budget. Health Policy . 1995,34:135-43
27.
Johannesson M, Johansson PO, Soderqvist T.Time spent on waiting lists for medical care an insurance approachJ Health Econ.1998;17:627-44.
28.
Propper C.Contingent valuation of time spent on NHS waiting lists. The Economic Journal1990;100:193-9.
29.
Ryan MUsing conjoint analysis to assess women's preferences for miscarriage management. Health Econ. 1997;6: 261-73
30.
Chapman S, Wong WLIncentives for questionnaire respondents. Aust J Public Health. 1991;15:66-7.
31.
Kristrom BComparing continuous and discrete contingent valuation questions. Environmental and Resource Economics.1993,3:63-71.
32.
Holmes TP, Kramer RA.An independent sample test of yeasaying and starting point bias in dichotomous-choice contingent valuation. J Environmental Economics and Management1995;29:121-32.
33.
Herriges JA, Shogren JF.Starting point bias in dichotomous choice. J Environmental Economics and Management.1996; 30:112-31
34.
Kealy MJ, Turner RW.A test of the equality of closed-ended and open-ended contingent valuations. Am J Agricultural Economics1993;75:321-31
35.
Sellar C, Stoll JR, Chavas JP.Validation of empirical measures of welfare change a comparison of nonmarket techniques. Land Economics.1985;61:156-75.
36.
Kealy MJ, Dovidio JF, Rochel ML.Accuracy in valuation is a matter of degree. Land Economics.1988;65:158-71
37.
Walsh RG, Johnson DM, McKean JR.Issues in nonmarket valuation and policy application: a retrospective glanceWestern J Agricultural Economics1989;14:178-88.
38.
Boyle KJ, Bishop RC.Welfare measurements using contingent valuation. a comparison of techniquesAm J Agricultural Economics. 1988;Feb:20-8
39.
Green D, Jacowitz KE, Kahnemann D, McFadden D.Referendum contingent valuation, anchoring, and willingness to pay for public goods. Resource and Energy Economics.1998; 20:85-116
40.
Bateman IJ, Langford IH, Turner RK, Willis KG, Garrod GD.Elicitation and truncation effects in contingent valuation studiesEcological Economics. 1995,12.161-79
41.
Brown TC, Champ PA, Bishop RC, McCollum DW.Which response format reveals the truth about donations to a public good?Land Economics.1996,72:152-66
42.
Boyle KJ, Johnson FR, McCollum DW, Desvousges WH, Dun-ford RW , Hudson SPValuing public goods: discrete versus continuous contingent-valuation responses. Land Economics1996;72:381-96.
43.
Bohm PEstimating demand for public goods. an experiment. European Economic Review . 1972,3.111-30
44.
Brookshire DS, Ives BC, Schulze WD.The valuation of aesthetic preferences. J Environmental Economics and Management1976,3325-46
45.
Rowe RD, d'Arge RC, Brookshire DSAn experiment on the economic value of visibilityJ Environmental Economics and Management1980;7.1-19.
46.
Scherr BA, Babb EM.Pricing public goods. an experiment with two proposed pricing systems. Public Choice1975,23: 35-48.
47.
Smith VL.The principle of unanimity and voluntary consent in social choiceJ Political Economy. 1977;85:1125-39.
48.
Smith VLResearch in Experimental Economics Vol 1. Greenwich, CTJAI Press, 1979
49.
Bohm PRevealing demand for an actual public good. J Public Economics1984;24:135-51
50.
Brubaker ER.Demand disclosures and conditions on exclusion: an experiment. Economic J.1984;94:536-53
51.
Throsby CD, Withers GA.Strategic bias and demand for public goods: theory and an application to the artsJ Public Economics1986,31:307-27.
52.
Gregory R.Interpreting measures of economic loss evidence from contingent valuation and experimental studies. J Environmental Economics and Management.1986;13:325-37
53.
Gregory R, Lichtenstein S, Slovic P.Valuing environmental resources: a constructive approachJ Risk and Uncertainty1993,7:177-97.
54.
54 Slovic P, Fischhoff B, Lichtenstein S.Facts and fears understanding perceived risk. In: Schwing RC, Albers WA (eds). Societal Risk Assessment How Safe is Safe Enough?New York, Plenum Press, 1980.
55.
Slovic P, Griffin D, Tversky ACompatibility effects in judgment and choice In Hogarth RM (ed) Insights in Decision Making. A Tribute to Hillel J. EinhornChicago, IL: University of Chicago Press, 1990.
56.
56 Schkade DA, Payne JW.Where do the numbers come from? How people respond to contingent valuation questions. In. Hausman JA (ed). Contingent Valuation: A Critical Assessment. New York: North Holland, 1993.
57.
Kahneman D, Knetsch J.Valuing public goods the purchase of moral satisfaction . J Environmental Economics and Management.1992;22:57-70
58.
Kahneman D, Ritov I.Determinants of stated WTP for public goods a study in the headline methodJ Risk and Uncertainty. 1994;9:538
59.
Schkade DA, Payne JW.How people respond to contingent valuation questions: a verbal protocol analysis of willingness to pay for an environmental regulation . J Environmental Economics and Management1994;26:88-109.
60.
Kanninen BBias in discrete response contingent valuation. J Environmental Economics and Management. 1995;28:114-25
61.
O'Brien B, Gafni A.When do the "dollars" make sense? Toward a conceptual framework for contingent valuation studies in health care. Med Decis Making.1996;16:288-99
62.
Kahneman D, Slovic P, Tversky A.Judgement Under Uncertainty: Heuristics and Biases. New York: Cambridge University Press, 1982.
63.
Boyle K, Bishop R, Welsh MStarting point bias in contingent valuation surveys. Land Economics . 1985,61:188-94
64.
Li CZ, Mattson L.Discrete choice under preference uncertainty. an improved structural model for contingent valuation. J Environmental Economics and Management. 1995;28: 256-69.
65.
Mitchell RC, Carson RT.Current Issues in the Design, Administration and Analysis of Contingent Valuation Surveys. Working Paper, Department of Economics, University of California, San Diego, CA, 1993.
66.
Nyquist H.Optimal designs of discrete response experiments in contingent valuation studies. Review of Economics and Statistics. 1992;74:559-63.
67.
Kanninen BJ.Optimal experimental design for double-bounded dichotomous choice contingent valuation. Land Economics1993;69:138-46.
68.
Alberini A, Carson RTChoice of thresholds for efficient binary discrete choice estimation Discussion Paper QE93-14, Resources for the FutureWashington, DC , 1993.
69.
Boyle K, Welsh M, Bishop R.Validation of empirical measures of welfare change: comment. Land Economics . 1988; 64:94-9.
70.
Cooper J.Optimal bid selection for dichotomous choice contingent valuation surveys. J Environmental Economics and Management.1993;24:25-40.
71.
Cooper J, Loomis JSensitivity of willingness to pay estimates to bid design in dichotomous choice contingent valuation models. Land Economics. 1992;68:211-24.
72.
Cooper J, Loomis JSensitivity of willingness to pay estimates to bid design in dichotomous choice contingent valuation models: reply. Land Economics. 1993;69:203-8
73.
Kanninen BJ, Kristrom B.Sensitivity of willingness to pay estimates to bid design in dichotomous choice valuation models: comment. Land Economics. 1993;69:199-202.
74.
Duffield JW, Patterson DAInference and optimal design for a welfare measure in dichotomous choice contingent valuationLand Economics1991;67:225-39.
75.
Alberini A.Optimal designs for discrete choice contingent valuation surveys: single bound, double bound, and bivariate models. J Environmental Economics and Management1995, 28:287-306.
76.
Cameron TA.A new paradigm for valuing non-market goods using referendum data: maximum likelihood estimation by censored logistic regression. J Environmental Economics and Management.1988;15:355-79.
77.
Johanson PO, Kristrom B, Maler KG.Welfare evaluations in contingent valuation experiments with discrete response data: comment. Am J Agricultural Econ1989 ;71:1054-6
78.
Hanemann WMWelfare evaluations in contingent valuation experiments with discrete response data: replyAm J Agricultural Economics1989;71:1057-61.
79.
Godfrey LG.Misspecification Tests in Econometrics: The Lagrange Multiplier Principle and Other ApproachesCambridge, U.K.: Cambridge University Press, 1988.
80.
Ozuna T, Jang KY, Stoll JR.Testing for misspecification in the referendum contingent valuation approach. Am J Agricultural Economics1993;75:332-8.
81.
Adelbasit KM, Plackett RL.Experimental design for binary dataJ Am Statistical Association. 1983;78:90-8
82.
Dorfman J, Kling C, Sexton R.Confidence intervals for elasticities and flexibilities: re-evaluating the ratio of the normals case. Am J Agricultural Economics.1990;72:1007-17.
83.
Langford IH, Bateman IJ.Welfare Measures for Contingent Valuation Studies: Estimation and Reliability. CSERGE GEC Working Paper 93-04, University of East Anglia, Norwich, U K., 1993.
84.
Adamowicz WL, Fletcher JJ, Grahman-Tomasi T.Functional form and the statistical properties of welfare measures . Am J Agricultural Economics. 1989;71:414-21.
85.
Efron B.Bootstrap methods another look at the jackknife. The Annals of Statistics.1979,7:1-26
86.
Cooper J.A comparison of approaches to calculating confidence intervals for benefit measures from dichotomous choice contingent valuation surveysLand Economics . 1994; 70:111-22.
87.
Langford IH.Using a generalised linear mixed model to analyse dichotomous choice contingent valuation data . Land Economics.1994;70:507-14
