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A new axiomatic approach to the evaluation of population health

  • Jens Leth Hougaard

    (Institute of Food and Resource Economics, University of Copenhagen)

  • Juan D. Moreno-Ternero

    (Department of Economics, Universidad Pablo de Olavide, and CORE, Université catholique de Louvain)

  • Lars Peter Østerdal

    (Department of Economics, University of Copenhagen.)

We explore in this paper the implications of ethical and operational principles for the evaluation of population health. We formalize those principles as axioms for social preferences over distributions of health for a given population. We single out several focal population health evaluation functions, which represent social preferences, as a result of combinations of those axioms. Our results provide rationale for popular theories in health economics (such as the unweighted aggregation of QALYs or HYEs, and generalizations of the two, aimed to capture concerns for distributive justice) without resorting to controversial assumptions over individual preferences.

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File URL: http://www.econ.ku.dk/english/research/publications/wp/dp_2011/1124.pdf
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Paper provided by University of Copenhagen. Department of Economics in its series Discussion Papers with number 11-24.

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Length: 20 pages
Date of creation: 11 Oct 2011
Date of revision:
Handle: RePEc:kud:kuiedp:1124
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  1. Bleichrodt, Han & Wakker, Peter & Johannesson, Magnus, 1997. "Characterizing QALYs by Risk Neutrality," Journal of Risk and Uncertainty, Springer, vol. 15(2), pages 107-14, November.
  2. FLEURBAEY, Marc & SCHOKKAERT, Erik, . "Unfair inequalities in health and health care," CORE Discussion Papers RP -2141, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  3. MORENO-TERNERO, Juan D. & ROEMER, John E., . "Impartiality, priority, and solidarity in the theory of justice," CORE Discussion Papers RP -1896, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  4. Han Bleichrodt & Jose Luis Pinto & Peter P. Wakker, 2001. "Making Descriptive Use of Prospect Theory to Improve the Prescriptive Use of Expected Utility," Management Science, INFORMS, vol. 47(11), pages 1498-1514, November.
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  6. Anne Spencer & Angela Robinson, 2007. "Tests of Utility Independence When Health Varies over Time," Working Papers 596, Queen Mary University of London, School of Economics and Finance.
  7. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
  8. 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.
  9. Marc Fleurbaey, 2007. "Assessing Risky Social Situations," IDEP Working Papers 0703, Institut d'economie publique (IDEP), Marseille, France, revised Jan 2007.
  10. Guerrero, Ana M. & Herrero, Carmen, 2005. "A semi-separable utility function for health profiles," Journal of Health Economics, Elsevier, vol. 24(1), pages 33-54, January.
  11. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
  12. William Thomson, 2001. "On the axiomatic method and its recent applications to game theory and resource allocation," Social Choice and Welfare, Springer, vol. 18(2), pages 327-386.
  13. Doctor, Jason N. & Miyamoto, John & Bleichrodt, Han, 2009. "When are person tradeoffs valid?," Journal of Health Economics, Elsevier, vol. 28(5), pages 1018-1027, September.
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  15. Weinstein, Milton C., 1988. "A QALY is a QALY is a QALY -- Or is it?," Journal of Health Economics, Elsevier, vol. 7(3), pages 289-290, September.
  16. John M. Miyamoto & Peter P. Wakker & Han Bleichrodt & Hans J. M. Peters, 1998. "The Zero-Condition: A Simplifying Assumption in QALY Measurement and Multiattribute Utility," Management Science, INFORMS, vol. 44(6), pages 839-849, June.
  17. Osterdal, Lars Peter, 2005. "Axioms for health care resource allocation," Journal of Health Economics, Elsevier, vol. 24(4), pages 679-702, July.
  18. Gafni, Amiram & Birch, Stephen & Mehrez, Abraham, 1993. "Economics, health and health economics: HYEs versus QALYs," Journal of Health Economics, Elsevier, vol. 12(3), pages 325-339, October.
  19. George W. Torrance, 1976. "Health Status Index Models: A Unified Mathematical View," Management Science, INFORMS, vol. 22(9), pages 990-1001, May.
  20. Bleichrodt, Han, 1995. "QALYs and HYEs: Under what conditions are they equivalent?," Journal of Health Economics, Elsevier, vol. 14(1), pages 17-37, May.
  21. Spencer, Anne & Robinson, Angela, 2007. "Tests of utility independence when health varies over time," Journal of Health Economics, Elsevier, vol. 26(5), pages 1003-1013, September.
  22. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the 'Fair Innings' Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132.
  23. Doctor, Jason N. & Bleichrodt, Han & Miyamoto, John & Temkin, Nancy R. & Dikmen, Sureyya, 2004. "A new and more robust test of QALYs," Journal of Health Economics, Elsevier, vol. 23(2), pages 353-367, March.
  24. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
  25. Bleichrodt, Han & Diecidue, Enrico & Quiggin, John, 2004. "Equity weights in the allocation of health care: the rank-dependent QALY model," Journal of Health Economics, Elsevier, vol. 23(1), pages 157-171, January.
  26. Culyer, A. J. & Wagstaff, Adam, 1993. "QALYs versus HYEs," Journal of Health Economics, Elsevier, vol. 12(3), pages 311-323, October.
  27. Gerard Debreu, 1959. "Topological Methods in Cardinal Utility Theory," Cowles Foundation Discussion Papers 76, Cowles Foundation for Research in Economics, Yale University.
  28. Spencer, Anne, 2003. "A test of the QALY model when health varies over time," Social Science & Medicine, Elsevier, vol. 57(9), pages 1697-1706, November.
  29. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February.
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