IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v14y2005i8p817-829.html
   My bibliography  Save this article

QALYs and the capability approach

Author

Listed:
  • Richard Cookson

Abstract

This explores the applicability of Sen's capability approach to the economic evaluation of health care programmes. An individual's ‘capability set’ describes his freedom to choose valuable activities and states of being (‘functionings’). Direct estimation and valuation of capability sets is not feasible at present. Standard preference‐based methods such as willingness to pay are feasible, but problematic due to the adaptive and constructed nature of individual preferences over time and under uncertainty. An alternative is to re‐interpret the QALY as a cardinal and interpersonally comparable index of the value of the individual's capability set. This approach has limitations, since the link between QALYs and capabilities is not straightforward. Nevertheless, the QALY approach is recognisable as an application of the capability approach since it pays close attention to functionings, through the use of survey‐based multi‐attribute health state valuation instruments, and permits conceptions of value other than the traditional utilitarian ones of choice, desire‐fulfilment and happiness. Furthermore, suitably re‐interpreted, it can account for (i) non‐separability between health and non‐health components of value; and suitably modified it can also account for (ii) process attributes of care, which may have a direct effect on non‐health functionings such as comfort and dignity, and (iii) sub‐group diversity in the value of the same health functionings. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • Richard Cookson, 2005. "QALYs and the capability approach," Health Economics, John Wiley & Sons, Ltd., vol. 14(8), pages 817-829, August.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:8:p:817-829
    DOI: 10.1002/hec.975
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.975
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.975?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Anand, Paul, 2003. "The integration of claims to health-care: a programming approach," Journal of Health Economics, Elsevier, vol. 22(5), pages 731-745, September.
    2. 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.
    3. Anthony J. Culyer (ed.), 1991. "The Economics Of Health," Books, Edward Elgar Publishing, volume 0, number 541.
    4. Sakiko Fukuda-Parr, 2003. "The Human Development Paradigm: Operationalizing Sen'S Ideas On Capabilities," Feminist Economics, Taylor & Francis Journals, vol. 9(2-3), pages 301-317.
    5. Joshua A. Salomon & Christopher J.L. Murray, 2004. "A multi‐method approach to measuring health‐state valuations," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 281-290, March.
    6. Tania Burchardt & Julian Le Grand, 2002. "Constraint and Opportunity: Identifying Voluntary Non-Employment," CASE Papers case55, Centre for Analysis of Social Exclusion, LSE.
    7. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 34-58, Spring.
    8. Tania Burchardt & Julian Le Grand, 2002. "Constraint and Opportunity: Identifying Voluntary Non-Employment," CASE Papers 055, Centre for Analysis of Social Exclusion, LSE.
    9. Dolan, P. & Gudex, C. & Kind, P. & Williams, A., 1996. "Valuing health states: A comparison of methods," Journal of Health Economics, Elsevier, vol. 15(2), pages 209-231, April.
    10. Richard Cookson, 2003. "Willingness to pay methods in health care: a sceptical view," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 891-894, November.
    11. Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118, Elsevier.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rachel Baker & Angela Robinson, 2004. "Responses to standard gambles: are preferences ‘well constructed’?," Health Economics, John Wiley & Sons, Ltd., vol. 13(1), pages 37-48, January.
    2. Brouwer, Werner B.F. & Culyer, Anthony J. & van Exel, N. Job A. & Rutten, Frans F.H., 2008. "Welfarism vs. extra-welfarism," Journal of Health Economics, Elsevier, vol. 27(2), pages 325-338, March.
    3. Ortrud Lessmann & Jean-Michel Bonvin, 2011. "Job-satisfaction in the Broader Framework of the Capability Approach," management revue. Socio-economic Studies, Rainer Hampp Verlag, vol. 22(1), pages 84-99.
    4. Paul Anand & Laurence S. J. Roope & Anthony J. Culyer & Ron Smith, 2020. "Disability and multidimensional quality of life: A capability approach to health status assessment," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 748-765, July.
    5. Culyer, Anthony J. & Evans, Robert G., 1996. "Mark Pauly on welfare economics: Normative rabbits from positive hats," Journal of Health Economics, Elsevier, vol. 15(2), pages 243-251, April.
    6. Mark Sculpher & Amiram Gafni, 2001. "Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 317-324, June.
    7. Philippe Batifoulier & John Latsis & Jacques Merchiers, 2010. "Les priorités de la prise en charge financière des soins. Une approche par la philosophie du besoin," EconomiX Working Papers 2010-2, University of Paris Nanterre, EconomiX.
    8. Masson, Torsten & Leßmann, Ortrud, 2012. "Nachhaltigkeitsindikatoren und Capabilities: Anknüpfungspunkte aus der deutschen Nachhaltigkeitsforschung," UFZ Discussion Papers 07/2012, Helmholtz Centre for Environmental Research (UFZ), Division of Social Sciences (ÖKUS).
    9. Stolpe, Michael, 2003. "Ressourcen und Ergebnisse der globalen Gesundheitsökonomie: Einführung und Überblick," Kiel Working Papers 1177, Kiel Institute for the World Economy (IfW Kiel).
    10. Morton, Alec, 2014. "Aversion to health inequalities in healthcare prioritisation: A multicriteria optimisation perspective," Journal of Health Economics, Elsevier, vol. 36(C), pages 164-173.
    11. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February.
    12. Christine Le Clainche & Sandy Tubeuf, 2016. "Nudging, intervening or rewarding," Politics, Philosophy & Economics, , vol. 15(2), pages 170-189, May.
    13. Marco Guerrazzi & Ilham Ksebi, 2019. "Measuring Unemployment by Means of Official Data and Administrative Records: Empirical and Theoretical Perspectives," QUADERNI DI ECONOMIA DEL LAVORO, FrancoAngeli Editore, vol. 2019(110), pages 17-49.
    14. Kuklys, W. & Robeyns, I., 2004. "Sen’s Capability Approach to Welfare Economics," Cambridge Working Papers in Economics 0415, Faculty of Economics, University of Cambridge.
    15. Mansdotter, Anna & Lindholm, Lars & Ohman, Ann, 2004. "Women, men and public health--how the choice of normative theory affects resource allocation," Health Policy, Elsevier, vol. 69(3), pages 351-364, September.
    16. Alessandro Petretto, 2013. "On the Fuzzy Boundaries between Public and Private in Health-Care Organization and Funding Systems," Rivista di Politica Economica, SIPI Spa, issue 1, pages 327-370, January-M.
    17. Coast, Joanna, 2009. "Maximisation in extra-welfarism: A critique of the current position in health economics," Social Science & Medicine, Elsevier, vol. 69(5), pages 786-792, September.
    18. Karen Hofmann & Dominik Schori & Thomas Abel, 2013. "Self-Reported Capabilities Among Young Male Adults in Switzerland: Translation and Psychometric Evaluation of a German, French and Italian Version of a Closed Survey Instrument," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 114(2), pages 723-738, November.
    19. Cagliesi, Maria & Hawkes, Denise & De Vita, Riccardo, 2012. "A multidimensional approach to worklessness: a matter of opportunities, social factors and individual’s idiosyncrasies," Greenwich Papers in Political Economy 7747, University of Greenwich, Greenwich Political Economy Research Centre.
    20. Bleichrodt, Han & Quiggin, John, 2013. "Capabilities as menus: A non-welfarist basis for QALY evaluation," Journal of Health Economics, Elsevier, vol. 32(1), pages 128-137.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:14:y:2005:i:8:p:817-829. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.