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Do Ordering Effects Matter in Willingness-to-pay Studies of Health Care?


  • Jennifer Stewart
  • Eamon O'Shea

    (Department of Economics, National University of Ireland, Galway)

  • Cam Donaldson
  • Phil Shackley

    (Department of Economics, National University of Ireland, Galway)


Willingness-to-pay studies are increasingly being used in the evaluation of health care programmes. There are, however, methodological issues that need to be resolved before the potential of willingness-to-pay can be fully exploited as a tool for the economic evaluation of health care programmes. Of particular methodological interest are the consequences of varying the order in which willingness-to-pay questions are presented to respondents in contingent valuation studies. This paper examines the possibility of ordering effects in willingness-to-pay studies in health care. That is, when simultaneously asking willingness-to-pay questions about three health care programmes, does the order the programmes are presented have an impact on the reported willingness-to-pay? We present the results from a survey which allowed us to test for ordering effects and examine, in particular, if the respondent?s past experience with the health care service interacted with the ordering effects.

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  • Jennifer Stewart & Eamon O'Shea & Cam Donaldson & Phil Shackley, 2000. "Do Ordering Effects Matter in Willingness-to-pay Studies of Health Care?," Working Papers 0046, National University of Ireland Galway, Department of Economics, revised 2000.
  • Handle: RePEc:nig:wpaper:0046

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    1. 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.
    2. Carson, Richard & Flores, Nicholas E. & Hanemann, W. Michael, 1998. "Sequencing and Valuing Public Goods," Journal of Environmental Economics and Management, Elsevier, vol. 36(3), pages 314-323, November.
    3. Kahneman, Daniel & Knetsch, Jack L., 1992. "Valuing public goods: The purchase of moral satisfaction," Journal of Environmental Economics and Management, Elsevier, vol. 22(1), pages 57-70, January.
    4. Cam Donaldson & Ruth Thomas & David Torgerson, 1997. "Validity of open-ended and payment scale approaches to eliciting willingness to pay," Applied Economics, Taylor & Francis Journals, vol. 29(1), pages 79-84.
    5. Carson Richard T. & Mitchell Robert Cameron, 1995. "Sequencing and Nesting in Contingent Valuation Surveys," Journal of Environmental Economics and Management, Elsevier, vol. 28(2), pages 155-173, March.
    6. Chilton, S. M. & Hutchinson, W. G., 2000. "A note on the warm glow of giving and scope sensitivity in contingent valuation studies," Journal of Economic Psychology, Elsevier, vol. 21(4), pages 343-349, August.
    7. Bente Halvorsen, 1996. "Ordering effects in contingent valuation surveys," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 8(4), pages 485-499, December.
    8. Paul Dolan, 1997. "The Nature of Individual Preferences: A Prologue to Johannesson, Jonsson and Karlsson," Health Economics, John Wiley & Sons, Ltd., vol. 6(1), pages 91-93.
    9. Richard C. Ready & Jean C. Buzby & Dayuan Hu, 1996. "Differences between Continuous and Discrete Contingent Value Estimates," Land Economics, University of Wisconsin Press, vol. 72(3), pages 397-411.
    10. Klose, Thomas, 1999. "The contingent valuation method in health care," Health Policy, Elsevier, vol. 47(2), pages 97-123, May.
    11. Holmes Thomas P. & Kramer Randall A., 1995. "An Independent Sample Test of Yea-Saying and Starting Point Bias in Dichotomous-Choice Contingent Valuation," Journal of Environmental Economics and Management, Elsevier, vol. 29(1), pages 121-132, July.
    12. Alan Diener & Bernie O'Brien & Amiram Gafni, 1998. "Health care contingent valuation studies: a review and classification of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 313-326.
    13. Randall A. Kramer & D. Evan Mercer, 1997. "Valuing a Global Environmental Good: U.S. Residents' Willingness to Pay to Protect Tropical Rain Forests," Land Economics, University of Wisconsin Press, vol. 73(2), pages 196-210.
    14. Boyle Kevin J. & Welsh Michael P. & Bishop Richard C., 1993. "The Role of Question Order and Respondent Experience in Contingent-Valuation Studies," Journal of Environmental Economics and Management, Elsevier, vol. 25(1), pages 80-99, July.
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    JEL classification:

    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis


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