HEALTH-CARE CONTINGENT VALUATION STUDIES - A REVIEW AND CLASSIFICATION OF THE LITERATURE

Purpose: The contingent valuation method (CVM) is a survey-based appro ach for eliciting consumer's monetary valuations for programme benefit s for use in cost-benefit analysis (CBA). We used the conceptual frame work of O'Brien and Gafni (1996) to classify and critically appraise h ealth care CVM studies. Methods: Search of computerized health care an d economic citation databases (e.g. MEDLINE, ECONLIT) and manual searc h for papers published between 1984-1996 reporting primary data valuin g health programme benefits in monetary units by CVM using willingness -to-pay (WTP) or accept (WTA). We classified studies using both empiri cal (i.e. who was surveyed and how) and conceptual criteria (i.e. whic h measure of consumer utility was measured and why). Results: 48 CVM s tudies were retrieved; the majority (42) undertook money valuation in the context of cost benefit analysis (CBA), with the remainder being p ricing/demand studies. Among the 42 CBA studies, the consumer utility being measured (i.e. compensating (CV) vs. equivalent variation (EV) w as explicitly stated in only three (7%) studies). WTP was measured in 95% of studies and WTA in 5%. By cross-tabulation, 42 (91%) studies we re designed as WTP/CV, two (4%) were WTP/CV, two (4%) were WTA/CV and no studies used WTA/EV. Most studies were administered by mail (52%) w ith 38% being in-person interviews. Value elicitation techniques inclu ded open-ended questions (38%), payment cards (19%) discrete choice qu estions (26%) or bidding games (29%). Some form of construct validatio n tests, particularly associations between WTP and income, were done i n 21 studies (50%). Conclusions: (i) The number of health care CVM stu dies is growing rapidly and the majority are done in the context of CB A; (ii) there is wide variation among health care CVM studies in terms of the types of questions being posed and the elicitation formats bei ng used; (iii) classification and appraisal of the literature is diffi cult because reporting of methods and their relationship with the conc eptual framework of CBA is poor; (iii) the applicability to health car e of the CVM guidelines issued by the National Oceanic and Atmospheric Administration (NOAA) panel for environmental economics is unclear. ( C) 1998 John Wiley & Sons, Ltd.