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Are preferences over health states complete?

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Author Info

  • Alan Shiell
  • Janelle Seymour

    (Department of Public Health and Community Medicine, University of Sydney, Australia)

  • Penelope Hawe

    (Department of Public Health and Community Medicine, University of Sydney, Australia)

  • Sue Cameron

    (Department of Public Health and Community Medicine, University of Sydney, Australia)

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    Abstract

    Most applied work in health economics accepts, if only implicitly, the axiom of completeness. Preferences over health states or health services are assumed to be well formed. They are effectively 'data' waiting to be collected. An alternative perspective suggests that values are initially incomplete and are constructed rather than just revealed in the process of answering choice-related questions such as willingness to pay or standard gambles. What might appear as measurement error may, therefore, be a more deliberate process of reflection and deliberation. This paper reports on a study that assessed the completeness of health preferences. The results show a mixed pattern. For most of the sample, values were stable over repeat administration, suggesting completeness. However, one-third of participants deliberately changed their answers and suggested that the interview process had forced them to think about their values more deeply. While it is premature to draw conclusions from this small sample, the suggestion is that completeness cannot be taken for granted. Copyright © 2000 John Wiley & Sons, Ltd.

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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 9 (2000)
    Issue (Month): 1 ()
    Pages: 47-55

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    Handle: RePEc:wly:hlthec:v:9:y:2000:i:1:p:47-55

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    References

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    1. Mandy Ryan & Jenny Hughes, 1997. "Using Conjoint Analysis to Assess Women's Preferences for Miscarriage Management," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 261-273.
    2. Verhoef, C. G. & Maas, A. & Stalpers, L. J. A. & Verbeek, A. L. M. & Wobbes, Th. & van Daal, W. A. J., 1991. "The feasibility of additive conjoint measurement in measuring utilities in breast cancer patients," Health Policy, Elsevier, vol. 17(1), pages 39-50, February.
    3. Gregory, Robin & Lichtenstein, Sarah & Slovic, Paul, 1993. " Valuing Environmental Resources: A Constructive Approach," Journal of Risk and Uncertainty, Springer, vol. 7(2), pages 177-97, October.
    4. Mas-Colell, Andrew, 1974. "An equilibrium existence theorem without complete or transitive preferences," Journal of Mathematical Economics, Elsevier, vol. 1(3), pages 237-246, December.
    5. Loomes, Graham & Sugden, Robert, 1982. "Regret Theory: An Alternative Theory of Rational Choice under Uncertainty," Economic Journal, Royal Economic Society, vol. 92(368), pages 805-24, December.
    6. William Furlong & David Feeny & George Torrance & Ronald Barr & John Horsman, 1992. "Guide to Design and Development of Health-State Utility Instrumentation," Centre for Health Economics and Policy Analysis Working Paper Series 1990-09, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    7. Stigler, George J & Becker, Gary S, 1977. "De Gustibus Non Est Disputandum," American Economic Review, American Economic Association, vol. 67(2), pages 76-90, March.
    8. Dolan, P. & Gudex, C. & Kind, P. & Williams, A., 1996. "Valuing health states: A comparison of methods," Journal of Health Economics, Elsevier, vol. 15(2), pages 209-231, April.
    9. Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Maximizing health benefits vs egalitarianism: An Australian survey of health issues," Social Science & Medicine, Elsevier, vol. 41(10), pages 1429-1437, November.
    10. Gale, D. & Mas-Colell, A., 1975. "An equilibrium existence theorem for a general model without ordered preferences," Journal of Mathematical Economics, Elsevier, vol. 2(1), pages 9-15, March.
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    Citations

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    Cited by:
    1. Andrew J Lloyd, 2003. "Threats to the estimation of benefit: are preference elicitation methods accurate?," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 393-402.
    2. Paul Anand, 2002. "The Integration of Claims to Health-Care: a Programming Approach," Open Discussion Papers in Economics 45, The Open University, Faculty of Social Sciences, Department of Economics.
    3. Kirsten Howard & Glenn Salkeld & Kirsten McCaffery & Les Irwig, 2008. "HPV triage testing or repeat Pap smear for the management of atypical squamous cells (ASCUS) on Pap smear: is there evidence of process utility?," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 593-605.
    4. Mandy Ryan & Mabelle Amaya-Amaya, 2005. "' Threats ' to and hopes for estimating benefits," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 609-619.
    5. Mandy Ryan & Fernando San Miguel, 2003. "Revisiting the axiom of completeness in health care," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 295-307.
    6. Schwappach, David L.B. & Strasmann, Thomas J., 2006. ""Quick and dirty numbers"?: The reliability of a stated-preference technique for the measurement of preferences for resource allocation," Journal of Health Economics, Elsevier, vol. 25(3), pages 432-448, May.
    7. Semra Özdemir & Ateesha F. Mohamed & F. Reed Johnson & A. Brett Hauber, 2010. "Who pays attention in stated-choice surveys?," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 111-118.
    8. Jens Hougaard & Tue Tjur & Lars Østerdal, 2012. "On the meaningfulness of testing preference axioms in stated preference discrete choice experiments," The European Journal of Health Economics, Springer, vol. 13(4), pages 409-417, August.
    9. Neuman, Tzahi & Neuman, Einat & Neuman, Shoshana, 2010. "Explorations of the effect of experience on preferences for a health-care service," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 39(3), pages 407-419, June.
    10. Brazier, J, 2005. "Current state of the art in preference-based measures of health and avenues for further research," MPRA Paper 29762, University Library of Munich, Germany.
    11. Emily Lancsar & Jordan Louviere, 2006. "Deleting 'irrational' responses from discrete choice experiments: a case of investigating or imposing preferences?," Health Economics, John Wiley & Sons, Ltd., vol. 15(8), pages 797-811.

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