Willingness to pay for improved respiratory and cardiovascular health: A multiple-format, stated-preference approach

This study uses stated-preference (SP) analysis to measure willingness to p ay (WTP) to reduce acute episodes of respiratory and cardiovascular ill hea lth. The SP survey employs a modified version of the health state descripti ons used in the Quality of Well Being (QWB) Index. The four health state at tributes are symptom, episode duration, activity restrictions and cost. Pre ferences are elicited using two different SP formats: graded-pair and discr ete-choice. The different formats cause subjects to focus on different eval uation strategies. Combining two elicitation formats yields more valid and robust estimates than using only one approach. Estimates of indirect utility function parameters are obtained using advanc ed panel econometrics for each format separately and jointly. Socio-economi c differences in health preferences are modelled by allowing the marginal u tility of money relative to health attributes to vary across respondents. B ecause the joint model captures the combined preference information provide d by both elicitation formats, these model estimates are used to calculate WTP. The results demonstrate the feasibility of estimating meaningful WTP values for policy-relevant respiratory and cardiac symptoms, even from subjects w ho never have personally experienced these conditions. Furthermore, because WTP estimates are for individual components of health improvements, estima tes can be aggregated in various ways depending upon policy needs. Thus, us ing generic health attributes facilitates transferring WTP estimates for be nefit-cost analysis of a variety of potential health interventions. Copyrig ht (C) 2000 John Wiley & Sons, Ltd.