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A new axiomatic approach to the evaluation of population health

  • Jens L. Hougaard

    ()

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

  • Juan D. Moreno-Ternero

    ()

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

  • Lars P. Osterdal

    ()

    (Department of Business and Economics, University of Southern Denmark)

In this paper we explore the implications of normative 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 new rationale for popular theories in health economics, such as the unweighted aggregation of quality-adjusted life years (QALYs) or healthy years equivalents (HYEs) and generalizations of the two, aimed to capture concerns for distributive justice, without resorting to controversial assumptions on individual preferences.

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File URL: http://www.upo.es/serv/bib/wps/econ1208.pdf
File Function: First version, 2012
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Paper provided by Universidad Pablo de Olavide, Department of Economics in its series Working Papers with number 12.08.

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Length: 25 pages
Date of creation: Oct 2012
Date of revision:
Handle: RePEc:pab:wpaper:12.08
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  1. George W. Torrance, 1976. "Health Status Index Models: A Unified Mathematical View," Management Science, INFORMS, vol. 22(9), pages 990-1001, May.
  2. MORENO-TERNERO, Juan D. & ROEMER, John E., 2005. "Impartiality, priority, and solidarity in the theory of justice," CORE Discussion Papers 2005077, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  3. 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.
  4. 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.
  5. 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.
  6. Marc Fleurbaey, 2010. "Assessing Risky Social Situations," Journal of Political Economy, University of Chicago Press, vol. 118(4), pages 649-680, 08.
  7. Culyer, A. J. & Wagstaff, Adam, 1993. "QALYs versus HYEs," Journal of Health Economics, Elsevier, vol. 12(3), pages 311-323, October.
  8. Bleichrodt, Han, 1997. "Health utility indices and equity considerations," Journal of Health Economics, Elsevier, vol. 16(1), pages 65-91, February.
  9. repec:cup:cbooks:9780521887427 is not listed on IDEAS
  10. 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.
  11. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
  12. repec:cup:cbooks:9780521715348 is not listed on IDEAS
  13. 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.
  14. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the 'Fair Innings' Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132.
  15. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2007. "Unfair inequalities in health and health care," CORE Discussion Papers 2007090, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  16. 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.
  17. 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.
  18. 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.
  19. 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.
  20. Gerard Debreu, 1959. "Topological Methods in Cardinal Utility Theory," Cowles Foundation Discussion Papers 76, Cowles Foundation for Research in Economics, Yale University.
  21. 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.
  22. 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.
  23. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
  24. 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.
  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. 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.
  27. Osterdal, Lars Peter, 2005. "Axioms for health care resource allocation," Journal of Health Economics, Elsevier, vol. 24(4), pages 679-702, July.
  28. 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.
  29. Bleichrodt, Han, 1995. "QALYs and HYEs: Under what conditions are they equivalent?," Journal of Health Economics, Elsevier, vol. 14(1), pages 17-37, May.
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