Some issues in the application of closed-ended willingness to pay studies to valuing health goods: an application to antenatal care in Scotland

Limited resources coupled with unlimited demands means that decisions have to be made concerning the allocation of scarce health care resources. The e conomic instrument of willingness to pay (WTP) is one instrument that can b e used to help this decision-making process. Recommendations from the envir onmental economics literature suggest that the closed end (CE) WTP approach should be used. This approach is just beginning to be used to value health goods. This paper addresses the sensitivity of the closed-ended WTP approa ch to three issues: the design of the bid vector; the upper and lower limit s of integration; and the method of analysis. These are discussed with refe rence to a study looking at the value of alternative models of ante-natal c are in Scotland. The results are discussed and conclusions made concerning the use of the CE WTP instrument for valuing health goods.