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BMC Health Services Research
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences

Authors: Jesus Martín-Fernández, Elena Polentinos-Castro, Ma Isabel del Cura-González, Gloria Ariza-Cardiel, Victor Abraira, Ana Isabel Gil-LaCruz, Sonia García-Pérez

Published in: BMC Health Services Research | Issue 1/2014

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Abstract

Background

This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response.

Methods

Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject’s self-evaluation, and through lottery games.

Results

Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when “out of pocket” payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results.

Conclusions

WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning.
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Metadata
Title
Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences
Authors
Jesus Martín-Fernández
Elena Polentinos-Castro
Ma Isabel del Cura-González
Gloria Ariza-Cardiel
Victor Abraira
Ana Isabel Gil-LaCruz
Sonia García-Pérez
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-287

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