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Demand assessment and price-elasticity estimation of quality-improved primary health care in palestine: a contribution from the contingent valuation method

Author Info

Listed author(s):
  • Awad Mataria
  • Stéphane Luchini

    (Research Group in Quantitative Economics of Aix-Marseille (GREQAM-CNRS), and Institute of Public Economics (IDEP), Marseille, France)

  • Yousef Daoud

    (Department of Economics, Faculty of Commerce and Economics, Birzeit University, Birzeit, Palestine)

  • Jean-Paul Moatti

Abstract

This paper proposes a new methodology to assess demand and price-elasticity for health care, based on patients' stated willingness to pay (WTP) values for certain aspects of health care quality improvements. A conceptual analysis of how respondents consider contingent valuation (CV) questions allowed us to specify a probability density function of stated WTP values, and consequently, to model a demand function for quality-improved health care, using a parametric survival approach. The model was empirically estimated using a CV study intended to assess patients' values for improving the quality of primary health care (PHC) services in Palestine. A random sample of 499 individuals was interviewed following medical consultation in four PHC centers. Quality was assessed using a multi-attribute approach; and respondents valued seven specific quality improvements using a decomposed valuation scenario and a payment card elicitation technique. Our results suggest an inelastic demand at low user fees levels, and when the price-increase is accompanied with substantial quality-improvements. Nevertheless, demand becomes more and more elastic if user fees continue to rise. On the other hand, patients' reactions to price-increase turn out to depend on their level of income. Our results can be used to design successful health care financing strategies that include a consideration of patients' preferences and financial capacities. Copyright © 2007 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1216
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 16 (2007)
Issue (Month): 10 ()
Pages: 1051-1068

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Handle: RePEc:wly:hlthec:v:16:y:2007:i:10:p:1051-1068
DOI: 10.1002/hec.1216
Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Onwujekwe, Obinna & Hanson, Kara & Fox-Rushby, Julia, 2005. "Do divergences between stated and actual willingness to pay signify the existence of bias in contingent valuation surveys?," Social Science & Medicine, Elsevier, vol. 60(3), pages 525-536, February.
  2. 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.
  3. Stewart, Jennifer M. & O'Shea, Eamon & Donaldson, Cam & Shackley, Phil, 2002. "Do ordering effects matter in willingness-to-pay studies of health care?," Journal of Health Economics, Elsevier, vol. 21(4), pages 585-599, July.
  4. Foreit, James R. & Foreit, Karen G. Fleischman, 2003. "The reliability and validity of willingness to pay surveys for reproductive health pricing decisions in developing countries," Health Policy, Elsevier, vol. 63(1), pages 37-47, January.
  5. Cummings, Ronald G & Harrison, Glenn W & Rutstrom, E Elisabet, 1995. "Homegrown Values and Hypothetical Surveys: Is the Dichotomous Choice Approach Incentive-Compatible?," American Economic Review, American Economic Association, vol. 85(1), pages 260-266, March.
  6. Chernichovsky, Dov & Meesook, Oey Astra, 1986. "Utilization of health services in Indonesia," Social Science & Medicine, Elsevier, vol. 23(6), pages 611-620, January.
  7. Gyldmark, Marlene & Morrison, Gwendolyn C., 2001. "Demand for health care in Denmark: results of a national sample survey using contingent valuation," Social Science & Medicine, Elsevier, vol. 53(8), pages 1023-1036, October.
  8. Litvack, Jennie I. & Bodart, Claude, 1993. "User fees plus quality equals improved access to health care: Results of a field experiment in Cameroon," Social Science & Medicine, Elsevier, vol. 37(3), pages 369-383, August.
  9. Johannesson, Magnus & Jonsson, Bengt, 1991. "Economic evaluation in health care: Is there a role for cost-benefit analysis?," Health Policy, Elsevier, vol. 17(1), pages 1-23, February.
  10. Klose, Thomas, 1999. "The contingent valuation method in health care," Health Policy, Elsevier, vol. 47(2), pages 97-123, May.
  11. Mataria, Awad & Donaldson, Cam & Luchini, Stephane & Moatti, Jean-Paul, 2004. "A stated preference approach to assessing health care-quality improvements in Palestine: from theoretical validity to policy implications," Journal of Health Economics, Elsevier, vol. 23(6), pages 1285-1311, November.
  12. Onwujekwe, Obinna & Chima, Reginald & Shu, Elvis & Nwagbo, Douglas & Akpala, Cyril & Okonkwo, Paul, 2002. "Altruistic willingness to pay in community-based sales of insecticide-treated nets exists in Nigeria," Social Science & Medicine, Elsevier, vol. 54(4), pages 519-527, February.
  13. Peter Kennedy, 2003. "A Guide to Econometrics, 5th Edition," MIT Press Books, The MIT Press, edition 5, volume 1, number 026261183x, July.
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Cited by:

  1. Danyliv, Andriy & Groot, Wim & Gryga, Irena & Pavlova, Milena, 2014. "Willingness and ability to pay for physician services in six Central and Eastern European countries," Health Policy, Elsevier, vol. 117(1), pages 72-82.
  2. Pierre-Alexandre Mahieu & Romain Craste & Bengt Kriström & Pere Riera, 2014. "Non-market valuation in France: An overview of the research activity," Working Papers hal-01087365, HAL.
  3. Fosgerau, Mogens & Karlström, Anders, 2010. "The value of reliability," Transportation Research Part B: Methodological, Elsevier, vol. 44(1), pages 38-49, January.
  4. Chakravarty, Amiya K. & Werner, Adrian S., 2011. "Telecom service provider portal: Revenue sharing and outsourcing," European Journal of Operational Research, Elsevier, vol. 215(1), pages 289-300, November.
  5. Tambor, Marzena & Pavlova, Milena & Rechel, Bernd & Golinowska, Stanisława & Sowada, Christoph & Groot, Wim, 2014. "Willingness to pay for publicly financed health care services in Central and Eastern Europe: Evidence from six countries based on a contingent valuation method," Social Science & Medicine, Elsevier, vol. 116(C), pages 193-201.
  6. Rosas, Francisco & Acerenza, Santiago & Orazem, Peter, 2016. "Optimal pricing strategies for a cluster of goods: Own- and cross-price effects with correlated tastes," ISU General Staff Papers 201611300800001008, Iowa State University, Department of Economics.

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