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Does "process utility" exist? A case study of willingness to pay for laparoscopic cholecystectomy

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  • Donaldson, Cam
  • Shackley, Phil

Abstract

This paper is concerned with the concept of process utility in health care. The paper begins by outlining the reasons why it might be important to include process utility in health care evaluation. Problems in defining process and outcome are then outlined, after which the discussion turns to how process utility might be detected empirically. Willingness to pay (WTP) is suggested as one means of doing so. The methods and results of a survey to test for the existence of process utility using WTP applied to laparoscopic cholecystectomy are reported. Cholecystectomy patients on a hospital waiting list were asked about their WTP for laparoscopic rather than conventional cholecystectomy. Willingness to pay was used in two ways to examine whether process is in the utility function. First, respondents were randomly allocated to receive different descriptions of laparoscopic and conventional cholecystectomy; one group receiving a description of differences between the treatments in terms of outcomes only, whilst the other group received information on differences in the process of treatment as well as on differences in outcomes. The groups were then compared in terms of their WTP. Second, regression analysis was used to test for the association between WTP and respondents' ratings of reasons for their WTP, some of these reasons reflecting process aspects and others reflecting outcome aspects. The results lead to rejection of the hypothesis that information on process of care would lead to higher WTP. However, due to the design of the study and the difficulties in defining process and outcome, it cannot be concluded that process utility does not exist. The paper concludes by suggesting alternative methods of testing for the existence of process utility.

Suggested Citation

  • Donaldson, Cam & Shackley, Phil, 1997. "Does "process utility" exist? A case study of willingness to pay for laparoscopic cholecystectomy," Social Science & Medicine, Elsevier, vol. 44(5), pages 699-707, March.
  • Handle: RePEc:eee:socmed:v:44:y:1997:i:5:p:699-707
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    Cited by:

    1. John Brazier & Aki Tsuchiya, 2015. "Improving Cross-Sector Comparisons: Going Beyond the Health-Related QALY," Applied Health Economics and Health Policy, Springer, vol. 13(6), pages 557-565, December.
    2. Bower, Peter & King, Michael & Nazareth, Irwin & Lampe, Fiona & Sibbald, Bonnie, 2005. "Patient preferences in randomised controlled trials: Conceptual framework and implications for research," Social Science & Medicine, Elsevier, vol. 61(3), pages 685-695, August.
    3. Brouwer, Werner B.F. & Exel, N. Job A. van & Berg, Bernard van den & Bos, Geertruidis A.M. van den & Koopmanschap, Marc A., 2005. "Process utility from providing informal care: the benefit of caring," Health Policy, Elsevier, vol. 74(1), pages 85-99, September.
    4. Ryan, Mandy & Scott, David A. & Donaldson, Cam, 2004. "Valuing health care using willingness to pay: a comparison of the payment card and dichotomous choice methods," Journal of Health Economics, Elsevier, vol. 23(2), pages 237-258, March.
    5. A. Chapman & C. Taylor & A. Girling, 2014. "Are the UK Systems of Innovation and Evaluation of Medical Devices Compatible? The Role of NICE’s Medical Technologies Evaluation Programme (MTEP)," Applied Health Economics and Health Policy, Springer, vol. 12(4), pages 347-357, August.
    6. Klose, Thomas, 1999. "The contingent valuation method in health care," Health Policy, Elsevier, vol. 47(2), pages 97-123, May.
    7. 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.
    8. Nathalie Havet & Magali Morelle & Alexis Penot & Raphaël Remonnay, 2012. "The information content of the WTP-WTA gap: An empirical analysis among severely ill patients," Working Papers 1213, Groupe d'Analyse et de Théorie Economique Lyon St-Étienne (GATE Lyon St-Étienne), Université de Lyon.
    9. Goebbels, Adrienne F.G. & Lakerveld, Jeroen & Ament, André J.H.A. & Bot, Sandra D.M. & Severens, Johan L., 2012. "Exploring non-health outcomes of health promotion: The perspective of participants in a lifestyle behaviour change intervention," Health Policy, Elsevier, vol. 106(2), pages 177-186.
    10. Stéphane Luchini & Christel Protière & Jean-Paul Moatti, 2003. "Eliciting several willingness to pay in a single contingent valuation survey: application to health care," Health Economics, John Wiley & Sons, Ltd., vol. 12(1), pages 51-64.
    11. Wailoo, Allan & Anand, Paul, 2005. "The nature of procedural preferences for health-care rationing decisions," Social Science & Medicine, Elsevier, vol. 60(2), pages 223-236, January.
    12. Ryan, Mandy & Netten, Ann & Skatun, Diane & Smith, Paul, 2006. "Using discrete choice experiments to estimate a preference-based measure of outcome--An application to social care for older people," Journal of Health Economics, Elsevier, vol. 25(5), pages 927-944, September.
    13. Pedersen, Line Bjørnskov & Gyrd-Hansen, Dorte & Kjær, Trine, 2011. "The influence of information and private versus public provision on preferences for screening for prostate cancer: A willingness-to-pay study," Health Policy, Elsevier, vol. 101(3), pages 277-289, August.
    14. Lamiraud, Karine & von Bremen, Konrade & Donaldson, Cam, 2009. "The impact of information on patient preferences in different delivery patterns: A contingent valuation study of prescription versus OTC drugs," Health Policy, Elsevier, vol. 93(2-3), pages 102-110, December.
    15. Marc Le Menestrel, 2001. "A Process Approach to the Utility for Gambling," Theory and Decision, Springer, vol. 50(3), pages 249-262, May.
    16. Richard Abreu Lourenco & Marion Haas & Jane Hall & Rosalie Viney, 2017. "Valuing Meta-Health Effects for Use in Economic Evaluations to Inform Reimbursement Decisions: A Review of the Evidence," PharmacoEconomics, Springer, vol. 35(3), pages 347-362, March.
    17. Su, Tin Tin & Sanon, Mamadou & Flessa, Steffen, 2007. "Assessment of indirect cost-of-illness in a subsistence farming society by using different valuation methods," Health Policy, Elsevier, vol. 83(2-3), pages 353-362, October.
    18. Stuart Wright & Cheryl Jones & Katherine Payne & Nimarta Dharni & Fiona Ulph, 2015. "The Role of Information Provision in Economic Evaluations of Newborn Bloodspot Screening: A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 13(6), pages 615-626, December.
    19. Sukanya Tianviwat & Virasakdi Chongsuvivatwong & Stephen Birch, 2008. "Different dental care setting: does income matter?," Health Economics, John Wiley & Sons, Ltd., vol. 17(1), pages 109-118.

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