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Aggregation rules for cost–benefit analysis: a health economics perspective

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  • Josephine Borghi

Abstract

Few willingness‐to‐pay (WTP) studies in the health sector have used their results within a cost–benefit analysis (CBA), an essential step to informing resource allocation decisions. This paper provides an overview of aggregation methods, reviews current evidence of practice in the health sector, and presents estimates of the total economic value of a women's group programme to improve mother and newborn health using different aggregation rules. A contingent valuation survey was conducted with 93 women's group members, 70 female non‐members and 33 husbands. Aggregation was conducted with and without the values of non‐users, and with different units of aggregation. The unadjusted mean, median and a weighted mean transfer were used to aggregate values. Equity weights were introduced to adjust WTP for income. Total WTP more than doubled when the values of husbands were added to that of women, and increased over 10‐fold when the values of women who were not members of the group were added. The inclusion of non‐use values, and the unit of aggregation, had the greatest effect on results. Researchers must reach agreement on the most acceptable method of aggregating WTP values to promote the use of WTP in resource allocation decisions in the health sector. Copyright © 2007 John Wiley & Sons, Ltd.

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  • Josephine Borghi, 2008. "Aggregation rules for cost–benefit analysis: a health economics perspective," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 863-875, July.
    • Handle: RePEc:wly:hlthec:v:17:y:2008:i:7:p:863-875
    DOI: 10.1002/hec.1304
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    2. Martín-Fernández, Jesús & Gómez-Gascón, Tomás & Oliva-Moreno, Juan & del Cura-González, María Isabel & Domínguez-Bidagor, Julia & Beamud-Lagos, Milagros & Sanz-Cuesta, Teresa, 2010. "Perception of the economic value of primary care services: A willingness to pay study," Health Policy, Elsevier, vol. 94(3), pages 266-272, March.
    3. Jesús Martín-Fernández & Mª Isabel del Cura-González & Gemma Rodríguez-Martínez & Gloria Ariza-Cardiel & Javier Zamora & Tomás Gómez-Gascón & Elena Polentinos-Castro & Francisco Javier Pérez-Rivas & J, 2013. "Economic Valuation of Health Care Services in Public Health Systems: A Study about Willingness to Pay (WTP) for Nursing Consultations," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-9, April.
    4. Jesús Martín-Fernández & Gloria Ariza-Cardiel & Luz Mª Peña-Longobardo & Elena Polentinos-Castro & Juan Oliva-Moreno & Ana Isabel Gil-Lacruz & Héctor Medina-Palomino & Isabel del Cura-González, 2017. "“Gaining or losing”: The importance of the perspective in primary care health services valuation," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-14, December.
    5. Pantea Marius & Gligor Delia, 2013. "Estimating Qalys In The Western Region Of Romania €" The Case With Intervention," Annals of Faculty of Economics, University of Oradea, Faculty of Economics, vol. 1(1), pages 290-299, July.

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