Non-market resource allocation and the public’s interpretation of need: an empirical investigation in the context of health care
Abstract The concept of need is central to the non-market allocation of many public resources, although the definition of need to serve as a basis for such resource allocation often remains contested. This study uses a discrete-choice experiment to investigate the general public’s interpretation of need in the context of health care resource allocation, focusing on three commonly cited definitions of need: need as a person’s baseline health status; need as a person’s ability-to-benefit; and need as the amount of resources required to exhaust a person’s ability-to-benefit. Analysis of participants’ need judgments using a latent-class, rank-ordered conditional logit model reveals that most individuals draw on all three definitions when assessing need, and that here is heterogeneity in interpretations of need among the public. Baseline health status is the most influential and consistent determinant of need, while ability-to-benefit and resources-required-to-exhaust-benefit are considered jointly. However, while some assign greater need to those who are worse off in the sense that they have little ability-to-benefit and require large amounts of resources to achieve that benefit, others assign greater need to those who have greater ability-to-benefit and whose benefit can be achieved with small amounts of resources. The public’s reasoning about need contrasts sharply in a number of ways with the types of arguments offered in the literature on needs-based resource allocation.
Volume (Year): 49 (2017)
Issue (Month): 1 (June)
|Contact details of provider:|| Web page: http://www.springer.com|
|Order Information:||Web: http://www.springer.com/economics/economic+theory/journal/355|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Konow, James, 2001. "Fair and square: the four sides of distributive justice," Journal of Economic Behavior & Organization, Elsevier, vol. 46(2), pages 137-164, October.
- Shah, Koonal K., 2009. "Severity of illness and priority setting in healthcare: A review of the literature," Health Policy, Elsevier, vol. 93(2-3), pages 77-84, December.
- Xavier Cuadras-Morató & José-Luis Pinto-Prades & José-María Abellán-Perpiñán, 2001. "Equity considerations in health care: the relevance of claims," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 187-205.
- Jennifer Whitty & Emily Lancsar & Kylie Rixon & Xanthe Golenko & Julie Ratcliffe, 2014. "A Systematic Review of Stated Preference Studies Reporting Public Preferences for Healthcare Priority Setting," The Patient: Patient-Centered Outcomes Research, Springer;Johns Hopkins Bloomberg School of Public Health, vol. 7(4), pages 365-386, December.
- Swait, Joffre & Adamowicz, Wiktor, 2001. " The Influence of Task Complexity on Consumer Choice: A Latent Class Model of Decision Strategy Switching," Journal of Consumer Research, Oxford University Press, vol. 28(1), pages 135-148, June.
- van Exel, Job & Baker, Rachel & Mason, Helen & Donaldson, Cam & Brouwer, Werner, 2015. "Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology," Social Science & Medicine, Elsevier, vol. 126(C), pages 128-137.
- Culyer, A. J., 1995. "Need: The idea won't do--But we still need it," Social Science & Medicine, Elsevier, vol. 40(6), pages 727-730, March.
- James Konow, 2003. "Which Is the Fairest One of All? A Positive Analysis of Justice Theories," Journal of Economic Literature, American Economic Association, vol. 41(4), pages 1188-1239, December.
- Greene, William H. & Hensher, David A., 2003. "A latent class model for discrete choice analysis: contrasts with mixed logit," Transportation Research Part B: Methodological, Elsevier, vol. 37(8), pages 681-698, September.
- Robertson, Ann, 1998. "Critical reflections on the politics of need: implications for public health," Social Science & Medicine, Elsevier, vol. 47(10), pages 1419-1430, November.
- Herlitz, Anders & Horan, David, 2016. "Measuring needs for priority setting in healthcare planning and policy," Social Science & Medicine, Elsevier, vol. 157(C), pages 96-102.
- Mentzakis, Emmanouil & Stefanowska, Patricia & Hurley, Jeremiah, 2011. "A discrete choice experiment investigating preferences for funding drugs used to treat orphan diseases: an exploratory study," Health Economics, Policy and Law, Cambridge University Press, vol. 6(03), pages 405-433, June.
- Richard D. Smith, 2007. "Use, option and externality values: are contingent valuation studies in health care mis-specified?," Health Economics, John Wiley & Sons, Ltd., vol. 16(8), pages 861-869.
- Aleksandra Gajic & David Cameron & Jeremiah Hurley, 2012. "The cost-effectiveness of cash versus lottery incentives for a web-based, stated-preference community survey," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(6), pages 789-799, December.
- Gu, Yuanyuan & Lancsar, Emily & Ghijben, Peter & Butler, James RG & Donaldson, Cam, 2015. "Attributes and weights in health care priority setting: A systematic review of what counts and to what extent," Social Science & Medicine, Elsevier, vol. 146(C), pages 41-52.
- Marlies Ahlert & Katja Funke & Lars Schwettmann, 2013. "Thresholds, productivity, and context: an experimental study on determinants of distributive behaviour," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 40(4), pages 957-984, April.
- Jeremiah Hurley & Neil Buckley & Katherine Cuff & Mita Giacomini & David Cameron, 2011. "Judgments regarding the fair division of goods: the impact of verbal versus quantitative descriptions of alternative divisions," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 37(2), pages 341-372, July.
When requesting a correction, please mention this item's handle: RePEc:spr:sochwe:v:49:y:2017:i:1:d:10.1007_s00355-017-1053-9. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sonal Shukla)or (Rebekah McClure)
If references are entirely missing, you can add them using this form.