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A new axiomatic approach to the evaluation of population health

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Author Info

  • Jens Leth Hougaard

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

  • Juan D. Moreno-Ternero

    (Department of Economics, Universidad Pablo de Olavide, and CORE, Université catholique de Louvain)

  • Lars Peter Østerdal

    (Department of Economics, University of Copenhagen.)

Abstract

We explore in this paper 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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Bibliographic Info

Paper provided by University of Copenhagen. Department of Economics in its series Discussion Papers with number 11-24.

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Length: 20 pages
Date of creation: 11 Oct 2011
Date of revision:
Handle: RePEc:kud:kuiedp:1124

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Keywords: population health; QALYs; HYEs; axioms;

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References

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  1. Culyer, A. J. & Wagstaff, Adam, 1993. "QALYs versus HYEs," Journal of Health Economics, Elsevier, vol. 12(3), pages 311-323, October.
  2. 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.
  3. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
  4. Fleurbaey,Marc & Maniquet,François, 2011. "A Theory of Fairness and Social Welfare," Cambridge Books, Cambridge University Press, number 9780521887427, October.
  5. Gerard Debreu, 1959. "Topological Methods in Cardinal Utility Theory," Cowles Foundation Discussion Papers 76, Cowles Foundation for Research in Economics, Yale University.
  6. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2007. "Unfair inequalities in health and health care," CORE Discussion Papers 2007090, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  7. George W. Torrance, 1976. "Health Status Index Models: A Unified Mathematical View," Management Science, INFORMS, vol. 22(9), pages 990-1001, May.
  8. MORENO-TERNERO, Juan D. & ROEMER, John E., . "Impartiality, priority, and solidarity in the theory of justice," CORE Discussion Papers RP -1896, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  9. 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.
  10. 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.
  11. FLEURBAEY, Marc, . "Assessing risky social situations," CORE Discussion Papers RP -2289, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
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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.
  14. Bleichrodt, Han & Diecidue, Enrico & Quiggin, John, 2004. "Equity weights in the allocation of health care: the rank-dependent QALY model," Journal of Health Economics, Elsevier, vol. 23(1), pages 157-171, January.
  15. 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.
  16. 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.
  17. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February.
  18. Bleichrodt, Han, 1995. "QALYs and HYEs: Under what conditions are they equivalent?," Journal of Health Economics, Elsevier, vol. 14(1), pages 17-37, May.
  19. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
  20. 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.
  21. 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.
  22. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
  23. Guerrero, Ana M. & Herrero, Carmen, 2005. "A semi-separable utility function for health profiles," Journal of Health Economics, Elsevier, vol. 24(1), pages 33-54, January.
  24. Spencer, Anne & Robinson, Angela, 2007. "Tests of utility independence when health varies over time," Journal of Health Economics, Elsevier, vol. 26(5), pages 1003-1013, September.
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  26. Weinstein, Milton C., 1988. "A QALY is a QALY is a QALY -- Or is it?," Journal of Health Economics, Elsevier, vol. 7(3), pages 289-290, September.
  27. 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.
  28. 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.
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Citations

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Cited by:
  1. 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.
  2. 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.

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