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Are preferences over health states complete?

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  • Alan Shiell
  • Janelle Seymour
  • Penelope Hawe
  • Sue Cameron

Abstract

Most applied work in health economics accepts, if only implicitly, the axiom of completeness. Preferences over health states or health services are assumed to be well formed. They are effectively ‘data’ waiting to be collected. An alternative perspective suggests that values are initially incomplete and are constructed rather than just revealed in the process of answering choice‐related questions such as willingness to pay or standard gambles. What might appear as measurement error may, therefore, be a more deliberate process of reflection and deliberation. This paper reports on a study that assessed the completeness of health preferences. The results show a mixed pattern. For most of the sample, values were stable over repeat administration, suggesting completeness. However, one‐third of participants deliberately changed their answers and suggested that the interview process had forced them to think about their values more deeply. While it is premature to draw conclusions from this small sample, the suggestion is that completeness cannot be taken for granted. Copyright © 2000 John Wiley & Sons, Ltd.

Suggested Citation

  • Alan Shiell & Janelle Seymour & Penelope Hawe & Sue Cameron, 2000. "Are preferences over health states complete?," Health Economics, John Wiley & Sons, Ltd., vol. 9(1), pages 47-55, January.
    • Handle: RePEc:wly:hlthec:v:9:y:2000:i:1:p:47-55
    DOI: 10.1002/(SICI)1099-1050(200001)9:1<47::AID-HEC485>3.0.CO;2-L
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    Cited by:

    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. Andrew J Lloyd, 2003. "Threats to the estimation of benefit: are preference elicitation methods accurate?," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 393-402, May.
    3. McKie, John & Richardson, Jeff, 2017. "Social preferences for prioritizing the treatment of severely ill patients: The relevance of severity, expected benefit, past health and lifetime health," Health Policy, Elsevier, vol. 121(8), pages 913-922.
    4. Scott, Anthony & Witt, Julia, 2020. "Loss aversion, reference dependence and diminishing sensitivity in choice experiments," Journal of choice modelling, Elsevier, vol. 37(C).
    5. Brazier, J, 2005. "Current state of the art in preference-based measures of health and avenues for further research," MPRA Paper 29762, University Library of Munich, Germany.
    6. Jens Hougaard & Tue Tjur & Lars Østerdal, 2012. "On the meaningfulness of testing preference axioms in stated preference discrete choice experiments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 409-417, August.
    7. Alan Shiell & Lisa Gold, 2003. "If the price is right: vagueness and values clarification in contingent valuation," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 909-919, November.
    8. Shiell, Alan & Gold, Lisa, 2002. "Contingent valuation in health care and the persistence of embedding effects without the warm glow," Journal of Economic Psychology, Elsevier, vol. 23(2), pages 251-262, April.
    9. Mandy Ryan & Mabelle Amaya‐Amaya, 2005. "‘Threats’ to and hopes for estimating benefits," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 609-619, June.
    10. 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, May.
    11. Emily Lancsar & Jordan Louviere, 2006. "Deleting ‘irrational’ responses from discrete choice experiments: a case of investigating or imposing preferences?," Health Economics, John Wiley & Sons, Ltd., vol. 15(8), pages 797-811, August.
    12. John McKie & Bradley Shrimpton & Jeff Richardson & Rosalind Hurworth, 2011. "The monetary value of a life year: evidence from a qualitative study of treatment costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 945-957, August.
    13. Semra Özdemir & Ateesha F. Mohamed & F. Reed Johnson & A. Brett Hauber, 2010. "Who pays attention in stated‐choice surveys?," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 111-118, January.
    14. Mandy Ryan & Fernando San Miguel, 2003. "Revisiting the axiom of completeness in health care," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 295-307, April.
    15. Schwappach, David L.B. & Strasmann, Thomas J., 2006. ""Quick and dirty numbers"?: The reliability of a stated-preference technique for the measurement of preferences for resource allocation," Journal of Health Economics, Elsevier, vol. 25(3), pages 432-448, May.
    16. Neuman, Tzahi & Neuman, Einat & Neuman, Shoshana, 2010. "Explorations of the effect of experience on preferences for a health-care service," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 39(3), pages 407-419, June.
    17. Nancy J. Devlin & Koonal K. Shah & Brendan J. Mulhern & Krystallia Pantiri & Ben van Hout, 2019. "A new method for valuing health: directly eliciting personal utility functions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(2), pages 257-270, March.
    18. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    19. Gabriela D. Oliveira & Luis C. Dias, 2020. "The potential learning effect of a MCDA approach on consumer preferences for alternative fuel vehicles," Annals of Operations Research, Springer, vol. 293(2), pages 767-787, October.

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