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A new axiomatic approach to the evaluation of population health

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  • Jens L. Hougaard

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

  • Juan D. Moreno-Ternero

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

  • Lars P. Osterdal

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

Abstract

In this paper we explore the implications of normative 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 new rationale for popular theories in health economics, such as the unweighted aggregation of quality-adjusted life years (QALYs) or healthy years equivalents (HYEs) and generalizations of the two, aimed to capture concerns for distributive justice, without resorting to controversial assumptions on individual preferences.

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File URL: http://www.upo.es/serv/bib/wps/econ1208.pdf
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Bibliographic Info

Paper provided by Universidad Pablo de Olavide, Department of Economics in its series Working Papers with number 12.08.

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Length: 25 pages
Date of creation: Oct 2012
Date of revision:
Handle: RePEc:pab:wpaper:12.08

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Keywords: population health; social preferences; QALYs; HYEs; axioms;

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References

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  1. 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.
  2. 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.
  3. George W. Torrance, 1976. "Health Status Index Models: A Unified Mathematical View," Management Science, INFORMS, vol. 22(9), pages 990-1001, May.
  4. 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.
  5. 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.
  6. Marc Fleurbaey, 2009. "Assessing risky social situations," LSE Research Online Documents on Economics 27006, London School of Economics and Political Science, LSE Library.
  7. 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.
  8. 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.
  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. 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.
  11. 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.
  12. 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.
  13. Gerard Debreu, 1959. "Topological Methods in Cardinal Utility Theory," Cowles Foundation Discussion Papers 76, Cowles Foundation for Research in Economics, Yale University.
  14. Culyer, A. J. & Wagstaff, Adam, 1993. "QALYs versus HYEs," Journal of Health Economics, Elsevier, vol. 12(3), pages 311-323, October.
  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. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
  17. Bleichrodt, Han, 1995. "QALYs and HYEs: Under what conditions are they equivalent?," Journal of Health Economics, Elsevier, vol. 14(1), pages 17-37, May.
  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. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
  20. 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.
  21. Osterdal, Lars Peter, 2005. "Axioms for health care resource allocation," Journal of Health Economics, Elsevier, vol. 24(4), pages 679-702, July.
  22. Fleurbaey,Marc & Maniquet,François, 2011. "A Theory of Fairness and Social Welfare," Cambridge Books, Cambridge University Press, number 9780521715348, April.
  23. 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.
  24. 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.
  25. 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.
  26. 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.
  27. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
  28. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February.
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Citations

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Cited by:
  1. Aitor Calo-Blanco, 2014. "Fairness, freedom, and forgiveness in health care," Social Choice and Welfare, Springer, vol. 43(1), pages 141-151, June.
  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.
  3. 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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