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End-of-life healthcare expenditure: Testing economic explanations using a discrete choice experiment


Fischer, Barbara; Telser, Harry; Zweifel, Peter (2018). End-of-life healthcare expenditure: Testing economic explanations using a discrete choice experiment. Journal of Health Economics, 60:30-38.

Abstract

Healthcare expenditure (HCE) spent during an individual’s last year of life accounts for a high share of lifetime HCE. This finding is puzzling because an investment in health is unlikely to have a sufficiently long payback period. However, Becker et al. (2007) and Philipson et al. (2010) have advanced a theory designed to explain high willingness to pay (WTP) for an extension of life close to its end. Their testable implications are complemented by the concept of ‘pain of risk bearing’ introduced by Eeckhoudt and Schlesinger (2006). They are tested using a discrete choice experiment performed in 2014, involving 1,529 Swiss adults. An individual setting where the price attribute is substantial out-of-pocket payment for a novel drug for treatment of terminal cancer is distinguished from a societal one, where it is an increase in contributions to social health insurance. Most of the economic predictions receive empirical support.

Abstract

Healthcare expenditure (HCE) spent during an individual’s last year of life accounts for a high share of lifetime HCE. This finding is puzzling because an investment in health is unlikely to have a sufficiently long payback period. However, Becker et al. (2007) and Philipson et al. (2010) have advanced a theory designed to explain high willingness to pay (WTP) for an extension of life close to its end. Their testable implications are complemented by the concept of ‘pain of risk bearing’ introduced by Eeckhoudt and Schlesinger (2006). They are tested using a discrete choice experiment performed in 2014, involving 1,529 Swiss adults. An individual setting where the price attribute is substantial out-of-pocket payment for a novel drug for treatment of terminal cancer is distinguished from a societal one, where it is an increase in contributions to social health insurance. Most of the economic predictions receive empirical support.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:03 Faculty of Economics > Department of Business Administration
Dewey Decimal Classification:330 Economics
Scopus Subject Areas:Health Sciences > Health Policy
Health Sciences > Public Health, Environmental and Occupational Health
Language:English
Date:July 2018
Deposited On:22 Aug 2019 14:51
Last Modified:29 Jul 2020 11:10
Publisher:Elsevier
ISSN:0167-6296
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.jhealeco.2018.06.001
Other Identification Number:merlin-id:17079

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