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A New Axiomatic Approach to the Evaluation of Population Health

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Author Info

  • Jens Leth Hougaard

    ()
    (Department of Food and Resource Economics, University of Copenhagen)

  • Juan D. Moreno-Ternero

    (Department of Economics, Universidad Pablo de Olavide)

  • Lars Peter Østerdal

    ()
    (Department of Business and Economics, University of Southern Denmark)

Abstract

In this paper we explore the implications of ethical and operational principles for the evaluation of population health. We formalize those principles as axioms for social preferences over distributions of health for a given population. We single out several focal population health evaluation functions, which represent social preferences, as a result of combinations of those axioms. Our results provide rationale for popular theories in health economics (such as the unweighted aggregation of QALYs or HYEs, and generalizations of the two, aimed to capture concerns for distributive justice) without resorting to controversial assumptions over individual preferences.

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File URL: http://okonomi.foi.dk/workingpapers/MSAPpdf/MSAP2012/MSAP_WP07_2012.pdf
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Bibliographic Info

Paper provided by University of Copenhagen, Department of Food and Resource Economics in its series MSAP Working Paper Series with number 07_2012.

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Length: 24 pages
Date of creation: Mar 2012
Date of revision:
Handle: RePEc:foi:msapwp:07_2012

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Web page: http://www.msap.life.ku.dk/
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Keywords: population health; QALYs; HYEs; axioms;

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References

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  2. Anne Spencer & Angela Robinson, 2007. "Tests of Utility Independence When Health Varies over Time," Working Papers 596, Queen Mary, University of London, School of Economics and Finance.
  3. Juan D Moreno-Ternero & John E Roemer, 2006. "Impartiality, Priority, and Solidarity in the Theory of Justice," Econometrica, Econometric Society, vol. 74(5), pages 1419-1427, 09.
  4. Gerard Debreu, 1959. "Topological Methods in Cardinal Utility Theory," Cowles Foundation Discussion Papers 76, Cowles Foundation for Research in Economics, Yale University.
  5. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
  6. Marc Fleurbaey, 2007. "Assessing Risky Social Situations," IDEP Working Papers 0703, Institut d'economie publique (IDEP), Marseille, France, revised Jan 2007.
  7. Doctor, Jason N. & Miyamoto, John & Bleichrodt, Han, 2009. "When are person tradeoffs valid?," Journal of Health Economics, Elsevier, vol. 28(5), pages 1018-1027, September.
  8. Han Bleichrodt & Jose Luis Pinto & Peter P. Wakker, 2001. "Making Descriptive Use of Prospect Theory to Improve the Prescriptive Use of Expected Utility," Management Science, INFORMS, vol. 47(11), pages 1498-1514, November.
  9. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
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  13. Spencer, Anne, 2003. "A test of the QALY model when health varies over time," Social Science & Medicine, Elsevier, vol. 57(9), pages 1697-1706, November.
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  15. Culyer, A. J. & Wagstaff, Adam, 1993. "QALYs versus HYEs," Journal of Health Economics, Elsevier, vol. 12(3), pages 311-323, October.
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  17. Gafni, Amiram & Birch, Stephen & Mehrez, Abraham, 1993. "Economics, health and health economics: HYEs versus QALYs," Journal of Health Economics, Elsevier, vol. 12(3), pages 325-339, October.
  18. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the 'Fair Innings' Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132.
  19. Fleurbaey,Marc & Maniquet,François, 2011. "A Theory of Fairness and Social Welfare," Cambridge Books, Cambridge University Press, number 9780521887427, Fall.
  20. John M. Miyamoto & Peter P. Wakker & Han Bleichrodt & Hans J. M. Peters, 1998. "The Zero-Condition: A Simplifying Assumption in QALY Measurement and Multiattribute Utility," Management Science, INFORMS, vol. 44(6), pages 839-849, June.
  21. Loomes, Graham & McKenzie, Lynda, 1989. "The use of QALYs in health care decision making," Social Science & Medicine, Elsevier, vol. 28(4), pages 299-308, January.
  22. Bleichrodt, Han, 1995. "QALYs and HYEs: Under what conditions are they equivalent?," Journal of Health Economics, Elsevier, vol. 14(1), pages 17-37, May.
  23. Bleichrodt, Han & Wakker, Peter & Johannesson, Magnus, 1997. "Characterizing QALYs by Risk Neutrality," Journal of Risk and Uncertainty, Springer, vol. 15(2), pages 107-14, November.
  24. William Thomson, 2001. "On the axiomatic method and its recent applications to game theory and resource allocation," Social Choice and Welfare, Springer, vol. 18(2), pages 327-386.
  25. Doctor, Jason N. & Bleichrodt, Han & Miyamoto, John & Temkin, Nancy R. & Dikmen, Sureyya, 2004. "A new and more robust test of QALYs," Journal of Health Economics, Elsevier, vol. 23(2), pages 353-367, March.
  26. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
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Cited by:
  1. Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2014. "Normative foundations for equity-sensitive population health evaluation functions," COHERE Working Paper 2014:1, COHERE - Centre of Health Economics Research, University of Southern Denmark.
  2. Jens L. Hougaard & Juan D. Moreno-Ternero & Lars P. Osterdal, 2013. "On the measurement of the (multidimensional) inequality of health distributions," Working Papers 13.02, Universidad Pablo de Olavide, Department of Economics.

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