Measuring Medical and Cost Uncertainty in Health Care Seeking: Instrument Design and Validation

Uncertainty about medical outcomes as well as about costs to seek care might play an important role in the health care decision-making process, potentially deterring sensible health care choices. There is little theoretical and no rigorous empirical evidence on this relationship, though, also owing to the lack of established tools to measure uncertainties around medical benefits and costs of health care seeking. In this paper, we develop such a measurement tool, field a first version of it in a low-income population in Pakistan, and present the initial evidence from this pilot data collection. We conduct a qualitative and quantitative validation process and identify potential for improvement in future applications. Nevertheless, the data collected through the tool appears meaningful and the analysis shows that on top of many biases, both medical as well as cost uncertainty is present to a substantial degree in our target population. Our empirical results also suggest that uncertainty in both dimensions deters health investments.