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Measuring the health of populations: the veil of ignorance approach


  • José-Luis Pinto-Prades

    (Department of Economics, Center for Health Economics, Pompeu Fabra University, Spain)

  • José-María Abellán-Perpiñán

    (Department of Applied Economics, University of Murcia, Spain)


We report the results from two surveys designed to explore whether an application of Harsanyi's principle of choice form behind a veil of ignorance (VEI) can be used in order to measure the health of populations. This approach was tentatively recommended by Murray et al. (Bull. World Health Organ 2000; 78 : 981-994; Summary Measures of population health: Concepts, Ethics, Measurement and Applications, WHO, 2002.) as an appropriate way of constructing summary measures of population health (SMPH) for comparative purposes. The operationalization of the VEI approach used in this paper was suggested by Nord (Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications, WHO, 2002.). We test if VEI and person trade-off (PTO) methods generate similar quality-of-life weights. In addition, we compare VEI and PTO weights with individual utilities estimated by means of the conventional standard gamble (SG) and a variation of it we call double gamble. Finally, psychometric properties like feasibility, reliability, and consistency are examined. Our main findings are next: (1) VEI and PTO approaches generate very different weights; (2) it seems that differences between PTO and VEI are not due to the 'rule of rescue'; (3) the VEI resembled more a DG than a classical SG; (4) PTO, VEI, and DG exhibited good feasibility, reliability and consistency. Copyright © 2004 John Wiley & Sons, Ltd.

Suggested Citation

  • José-Luis Pinto-Prades & José-María Abellán-Perpiñán, 2005. "Measuring the health of populations: the veil of ignorance approach," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 69-82.
  • Handle: RePEc:wly:hlthec:v:14:y:2005:i:1:p:69-82 DOI: 10.1002/hec.887

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    References listed on IDEAS

    1. Erik Nord & Paul Menzel & Jeff Richardson, 2003. "The value of life: individual preferences and social choice. A comment to Magnus Johannesson," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 873-877.
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    9. Bleichrodt, Han & Johannesson, Magnus, 1997. "Standard gamble, time trade-off and rating scale: Experimental results on the ranking properties of QALYs," Journal of Health Economics, Elsevier, vol. 16(2), pages 155-175, April.
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    Cited by:

    1. Stavros Petrou & Ngianga-Bakwin Kandala & Angela Robinson & Rachel Baker, 2013. "A Person Trade-Off Study to Estimate Age-Related Weights for Health Gains in Economic Evaluation," PharmacoEconomics, Springer, vol. 31(10), pages 893-907, October.
    2. Abellán Perpiñán, José Mª & Sánchez Martínez,Fernando I. & Martínez Pérez, Jorge E., 2007. "La medición del bienestar social relacionado con la salud/The Measurement of the Health Related Social Welfare," Estudios de Economía Aplicada, Estudios de Economía Aplicada, vol. 25, pages 927-950, Diciembre.
    3. Lars Østerdal, 2009. "The lack of theoretical support for using person trade-offs in QALY-type models," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(4), pages 429-436, October.
    4. Jose-Luis Pinto-Prades & Jorge-Eduardo Martinez-Perez & Jose-Maria Abellan-Perpinan, 2006. "The influence of the ratio bias phenomenon on the elicitation of health states utilities," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 1, pages 118-133, November.
    5. Han Bleichrodt & Jose Maria Abellan-Perpiñan & Jose Luis Pinto-Prades & Ildefonso Mendez-Martinez, 2007. "Resolving Inconsistencies in Utility Measurement Under Risk: Tests of Generalizations of Expected Utility," Management Science, INFORMS, vol. 53(3), pages 469-482, March.
    6. Eva Rodríguez Míguez & José María Abellán Perpiñán & José Carlos Álvarez Villamarín & José Manuel González Martínez & Antonio Rodríguez Sampayo, 2013. "Development of a new preference-based instrument to measure dependency," Working Papers 1301, Universidade de Vigo, Departamento de Economía Aplicada.
    7. Álvarez, Begoña & Rodríguez-Míguez, Eva, 2011. "Patients' self-interested preferences: Empirical evidence from a priority setting experiment," Social Science & Medicine, Elsevier, vol. 72(8), pages 1317-1324, April.
    8. Lars Peter Østerdal, 2004. "QALYs, Person Trade-Offs, and the Pareto Principle," Discussion Papers 04-10, University of Copenhagen. Department of Economics.
    9. Christopher Schwand & Rudolf Vetschera & Lea Wakolbinger, 2010. "The influence of probabilities on the response mode bias in utility elicitation," Theory and Decision, Springer, vol. 69(3), pages 395-416, September.
    10. Begoña Álvarez & Eva Rodríguez-Míguez, 2009. "Patients’ self-interest bias: Empirical evidence from a priority-setting experiment," Working Papers 0903, Universidade de Vigo, Departamento de Economía Aplicada.

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