La présente thèse explore, à travers quatre papiers, la possibilité d’étendre le régime d’assurance maladie sociale (SHI) vers la couverture santé universelle (CSU) et ce en présence d’obstacles structurels économiques.Les effets moyens de deux traitements, les deux assurances MHI et MAS, sur l’utilisation des soins de santé (consultations externes et hospitalisations) sont estimés. L’actuel régime d’assurance sociale en Tunisie (SHI), malgré l’amélioration de l’utilisation des soins de santé procurée aux groupes couverts, reste incapable d’atteindre une couverture effective de tous les membres de la population vis-à-vis des services de soins dont ils ont besoin. L’atteinte de cet objectif requière une stratégie qui cible les ‘‘arbres’’ et non la ‘‘forêt’’.Le chapitre deux contourne les principaux obstacles à l’extension de la couverture par l’assurance maladie et propose une approche originale permettant de cibler les travailleurs informels et les individus en chômage. Une étude transversale d’évaluation contingente (CV) a été menée en Tunisie se proposant d’estimer les volontés d’adhésion et les consentements à payer (WTP) pour deux régimes obligatoires présentés hypothétiquement à l’adhésion. Les résultats confirment l’hypothèse selon laquelle la proposition d’une affiliation volontaire à un régime d’assurance obligatoire serait acceptée par la majorité des non couverts et que les WTP révélés pour cette affiliation seraient substantiels. Enfin, dans le chapitre trois, on insiste sur l'’importance de prendre en compte les attitudes protestataires en évaluant la progression vers la CSU. / This thesis explores, in a four paper format, the possibility of extending social health insurance (SHI) schemes towards Universal Health Coverage (UHC) in presence of structural economic obstacles.The average treatment effects of two insurance schemes, MHI and MAS, on the utilization of outpatient and inpatient healthcare are estimated. The current Tunisian SHI schemes, despite improving utilization of healthcare services, are nevertheless incapable of achieving effective coverage of the whole population for needed services. Attaining the latter goal requires a strategy that targets the “trees” not the “forest”.Chapter two gets around major challenges to extending health insurance coverage and proposes an original approach by targeting informal workers and unemployed. A cross-sectional Contingent valuation (CV) study was carried out in Tunisia dealing with willingness-to-join and pay for two mandatory health and pension insurance schemes.Results support the hypotheses that the proposition of a voluntary affiliation to mandatory insurance schemes can be accepted by the majority of non-covered and that the WTP stated are substantial.Finally in chapter three we focus on methodological aspects that influence the value of the WTP. Our empirical results show that the voluntary affiliation to the formal health insurance scheme could be a step towards achieving UHC in Tunisia. Overall, we highlight the importance of taking into account protest positions for the evaluation of progress towards UHC.

Made available in DSpace on 2016-08-10T10:50:11Z (GMT). No. of bitstreams: 1 CLEUTON CLENES DA SILVA.pdf: 1417621 bytes, checksum: 3f9b7f8cea0cb7097d1e697b0a56809b (MD5) Previous issue date: 2012-12-20 / This study evaluates the spontaneous Willingness to Pay (WTP) of a proportion of the Goiania II and Sao Judas Tadeu Goiânia residents in order to reduce or eliminate the air pollution, supposedly generated by Goiania II ETE (Sewage Treatment System) and Unilever, which could result in improved quality of life for those who live nearby. The goal of the research was to put a price on environmental pollution, so it was decided to use the Contingent Valuation Method (CVM), as this is most frequently recommended and used when analyzing individual consumer preference in relation to the environmental goods or services at their disposal. As a field research technique, questionnaires were given to a sample of this population, with the aim of evaluating the interviewees conceptions in relation to the environmental issues exacerbated by the Goiania II ETE and Unilever. In order to justify and tabulate the answers found in the questionnaires, the SPSS statistical program was used for regression analyses. Spontaneous WTP was considered the dependent variable while the independent variables included income, education level, occupation, etc.. By means of the field research, it could be affirmed from the majority of interviewees responses that the problem of air pollution, from their conception, is associated in particular with the industries of the region. They further highlight that Government at all levels (local, state and federal) is negligent in terms of the environmental issues which affect the residents. It was concluded that the vast majority of respondents is not willing to pay to reduce or eliminate the existing air pollution that they have to put up with, allegedly for economic reasons. Respondents warn that the Goiania II ETE and Unilever need to improve collective sewage treatment and put environmental policies in place. / Esta pesquisa avalia a Disposição a Pagar (DAP) espontânea de um percentual dos habitantes dos setores Goiânia II e São Judas Tadeu de Goiânia, para diminuir ou desaparecer com o problema da poluição do ar gerado supostamente pela ETE Goiânia II e Unilever, o que poderá resultar na melhoria da qualidade de vida dos habitantes que vivem nas proximidades dessas empresas. O objetivo da pesquisa é, valorar a poluição ambiental, por isso, decidiu-se pelo Método de Valoração Contingente (MVC), devido ser o mais recomendado e utilizado para analisar a preferência individual dos consumidores em relação aos bens ou serviços ambientais disponibilizados a eles. A técnica utilizada na pesquisa de campo foi o uso de questionários a uma amostra dessa população, tendo como intuito, avaliar a concepção dos entrevistados em relação à questão ambiental agravada pela ETE Goiânia II e Unilever. Para justificar e tabular as respostas encontradas nos questionários foi utilizado o programa estatístico SPSS fazendo a análise de regressão. Considerou-se como variável dependente a Disposição a Pagar (DAP), e como variáveis independentes, a renda, o nível de escolaridade, profissão, etc. Pela pesquisa de campo, pôde-se afirmar através da maioria dos pesquisados, que o problema do ar poluído, nas suas concepções, está associado em especial às indústrias da região. Destacam ainda que, o Poder Público em todas as esferas (municipal, estadual e federal), são omissos no que diz respeito aos problemas ambientais que os afetam. Conclui-se ainda que, a grande maioria dos pesquisados, não estão dispostos a pagar uma taxa para diminuir ou desaparecer com a poluição do ar existente e que os atingem, alegando sobretudo, fatores econômicos. Os pesquisados alertam que, a ETE Goiânia II e a Unilever precisam fazer um tratamento melhor do esgoto coletivo e apliquem em políticas ambientais.

The goal of the work is to provide monetary valuation of changes in visual aspects of the landscape as a result of construction of an additional wind turbine in the village Maletín. For a suitable method for achieving the goal is being selected the contingent valuation method. A key element of this method is being considered the carefully compiled questionnaire, on which basis is made the quantification and evaluation of collected data. The representative sample consists of 112 households and the selected payment method is the increase of the monthly bill for electricity. The questionnaire reports that 54.3% of households consider the impact of wind turbines on the landscape Maletín to be positive. With the construction of additional wind turbine agree less than 74.3% of households and the most common reason is to obtain grants for the village and to produce cleaner energy from wind turbines. With the construction of new wind turbine while increasing monthly bill agrees 28.6% of all households living in the village Maletín. Estimation of changes in a welfare, thus improving the quality of the environment, is based on estimated central values, that has been calculated from selected characteristics and nonparametric estimation. The average household's willingness to pay for construction of wind turbine is estimated to be between 77 CZK - 200 CZK per month.

假設市場評價法（Contingent valuation）多用於評估有關某一非市場性財產（Non-market goods）或公共財（Public goods）在民眾心目中的願付價值（Willingness to pay, WTP）。探討受訪者願付價值之研究調查案的問卷設計方式，大致可分成五種，其中開放式出價法和逐步競價法已被證實會對估計造成偏誤，而支付卡法、二分選擇法和雙界二分選擇法則是現今較常為研究者所使用的價格詢問方法，本論文的研究是針對二分選擇法的最佳設計（Optimal design），作一深入的探討。 假設欲探究之母體的願付價值為一服從平均數為 、標準差為 的常態分配，若採用二分選擇法作為價格詢問的方式，則何種詢問方法才能讓參數估計最佳化，由模擬實驗的結果，我們知道若將受訪者隨機等分成兩群，分別詢問兩個不同的價格，且這兩個價格的平均等於預先猜測的母體平均數，那麼不但會有相當不錯的估計結果，在實際的執行上亦較方便。此外，我們提出較容易計算的參數估計量來代替傳統的最大概似估計量（MLE），並以數理證明保證了新的參數估計量有良好的估計性質。 願付價值的研究若對母體資訊不充分時，常會先採行前測（Pretest）。本論文除了探討二分選擇法的最佳設計之外，亦針對支付卡法和二分選擇法運用在前測時，作一深入的討論，結果發現當事先猜測的母體分配參數和真實分配相差很多下，支付卡法和二分選擇法會產生無法估計的情況，因此我們提出新的前測方法，試圖彌補這兩種傳統前測法的不足，我們稱之為序列詢問法（Sequence method）。序列詢問法為一種追蹤母體平均數的方式，依照現在這位受訪者的回答，決定下一位受訪者的詢問價格，在我們的研究中發現，如此的序列詢問方法比傳統的前測法利用更少的資訊，但仍然維持不錯的母體平均數估計結果。

臺灣西南沿海地區由於超抽地下水，地層下陷情形日益嚴重，究其原因乃地下水資源在國內仍處於「自由財」的狀態，用水兔費，使用自然缺乏效率，因而建立使用者付費制度，以確實維護地下水財產權，為當務之急。惟地下水資源具公共財的無排他性，在國內又無交易市場，其價值估算困難。是故，本文之主要目的，係應用非市場估價法中之「條件評價法」，以願付價格的形式估計地下水價值，並探求其影響因素，以做為制定政策之參考。 本文係以「準逐步競價法」為詢價結構設計，可同時獲得「單邊界樣本」、「雙邊界樣本」與「最終出價樣本」三種評價歷程，實證模型則分別以「Probit、Logit模型」、「存活模型」與「OLS模型」進行分析。 本文根據問卷調查的原始資料求出「每公頃土地」之地下水願付價格，最後則以台西地區為例，配合地下水的使用效益，計算出地下水供不同使用時之「使用價值」與「非使用價值」，而本研究對假設性問題的設計，使估計出來的地下水價值，亦可用以表示維護地下水資源對於防止地層下陷之效益。 實證結果顯示，「對水權費的認知與態度」以及「對地層下陷原因的認知」是影響支付意願的重要因素，故政府應加強宣導「使用者付費」理念，並教育用水者「超抽地下水是造成地層下陷的重要因素」，以利水權費制度的實施。

Diss. Stockholm : Handelshögskolan, 2006 S. 1-125 : 4 uppsatser

The aims of this thesis were to evaluate caries-preventive measures from a societal perspective, to demonstrate the use of resources in preventive dentistry, to develop and discuss techniques suitable for evaluating dental care costs and outcomes, and to test costs and consequences within a health economic decision model adapted to preventive dental care. The thesis is based on three separate studies with three separate cohorts. In the first study, performed at a single dental clinic, analysis was made of data on dental caries progression over four years in 92 adolescents, along with the use of resources for preventive treatment. In the second study, data from the intervention study “Evaluation of caries-preventive measures” (performed between 1995 and 1999 at 26 dental health clinics throughout Sweden) were used for economic evaluation. Three different approaches to calculating unit cost were discussed, each of which reflect the differences in treatment costs as influenced by the practitioner’s level of skill and competence (salary) and by methods of handling overhead cost allocation. These methods seem useful for evaluating costs in cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA). The CEA showed an incremental cost-effectiveness over four years of SEK 2 043* per averted decayed (D) enamel (e) and dentine caries, missing (M) and filled (F) surface (S) (DeMFS). In the third study, 82 19-year-old individuals agreed to participate in a pilot exploratory case-control study. Individuals with high caries experience formed the test group while the control group consisted of individuals with no caries experience. To explore whether any differences existed between these two groups in perceived oral health-related quality of life (OHRQOL), two OHRQOL measures were used. Additionally, the willingness of these individuals to pay (WTP) for a preventive strategy was elicited using the contingent valuation method (CVM) within a cost-benefit approach. Using these WTP values, the cost-benefit analyses showed positive net social benefit (NSB) values for both study groups, meaning that the benefits of prevention exceeded the costs. A new outcome measure, Value of Statistical Oral Health (VOSOH), was also presented. Consideration was also made, within the economic framework fundamental to this thesis, of the trend away from a strictly bio-medical paradigm towards a biopsychosocial perspective. The health economic decision model encompasses a number of different techniques for comparing costs with consequences, each with its own advantages and disadvantages and each with its own field of application. These techniques should be seen as complementary rather than competing. Preventive dentistry plays a central role in Swedish dental health care, and it is important that resources are used properly. Accurate evaluation methods are necessary in order to improve the basis for public decision-making; the methods proposed in this thesis seem to be of potential use in this endeavour. *SEK8.54 = US$1 (December 1999).

In Scotland, as the UK and internationally, publicly funded cultural organisations face a precarious future, characterised by funding cuts and a growing need to justify investments. This practical need to understand and articulate the importance of cultural resources has underpinned an intense debate in the field of cultural studies, about the nature of cultural value and the best methodological tools to explore it. The appropriateness of relying upon cultural strategies to pursue urban development and regeneration has also been subject to extensive discussions in the field of urban studies. This study approaches these problems through mixed-methods, comparative case studies set in Edinburgh and Dundee. This research employs Contingent Valuation (CV) in combination with focus groups. It provides a contextualised understanding of the diverging notions of culture emerging in the two cities. A higher valuation for culture was registered in Edinburgh, with stronger preference for museums and performing arts. In Dundee, higher importance was placed on community-based activities. These patterns are linked to the mix of demographic and socio-economic backgrounds characterising each city. Therefore, this study highlights a need for a tailored approach to cultural valuation and cultural policy, in contrast with the tendency for these to be implemented on a one-size-fit-all basis. The study also concludes that greater consideration is needed for the intangible and non-use related elements of cultural value, reinforcing a dominant critique in the literature. In addition, it highlights potential for negative sides to the impacts of cultural activities. Examples include issues of gentrification and displacement. Their inclusion is shown to be neglected in the typologies of value predominantly associated with culture, pointing at the need for their amendment. Finally, this study shows the use of CV alongside qualitative methods to be particularly advantageous in overcoming the dichotomous approach characterising this debate. The study avoided the single monetary valuation strongly rejected within the cultural sector, while still managing to yield grounded insight that is potentially valuable for policy-makers.

Made available in DSpace on 2014-12-17T15:55:05Z (GMT). No. of bitstreams: 1 DeborahQC_DISSERT.pdf: 1429454 bytes, checksum: a0c0f19a1e2b4dce92a5d361e8bb5d9a (MD5) Previous issue date: 2014-02-18 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Esta disserta??o teve como objetivo estimar os valores de uso, n?o-uso e o valor econ?mico total de unidades de conserva??o que protegem o ecossistema de dunas, atrav?s dos m?todos de Valora??o Contingente e do Custo de Viagem. O m?todo de Valora??o Contingente ? capaz de estimar o valor de n?o-uso de um recurso natural atrav?s da utiliza??o de um mercado hipot?tico que consiste em um cen?rio ambiental fict?cio em que o bem ambiental sofre varia??es em suas quantidades e os indiv?duos expressam suas prefer?ncias declarando quanto estariam dispostos a pagar (ou aceitar) para garantir a continuidade (ou a perda) da provis?o do bem. Neste estudo, foram aplicadas duas formas de pagamento para o mercado hipot?tico da t?cnica de Disposi??o a Pagar (coletiva/obrigat?ria e individual/volunt?ria) com o objetivo de identificar a demanda da popula??o por investimentos p?blicos nas unidades de conserva??o costeiras urbanas, para testar a efici?ncia de ambas formas de pagamento e para captar os votos de protesto dos entrevistados, na tentativa incorporar nas an?lises a verdadeira disposi??o a pagar dos entrevistados pela a manuten??o e conserva??o das unidades de conserva??o. Os resultados mostraram maiores lances de disposi??o a pagar para a forma de pagamento coletiva e obrigat?ria, pois em pa?ses em desenvolvimento as pessoas atribuem ao governo o financiamento da conserva??o de paisagens naturais. A diferen?a entre os valores de n?o-uso estimados pelas duas formas de pagamento foi de R$8,2 milh?es (3.5 milh?es) e isso representa a demanda da popula??o local por investimentos p?blicos na conserva??o das ?reas costeiras. O M?todo do Custo de Viagem foi utilizado para estimar o valor de uso das dunas, obtido a partir dos gastos incorridos pelos visitantes ao visitar as ?reas de dunas e o somat?rio deste valor ao valor de n?o-uso representa o valor econ?mico total agregado pela paisagem de parques dunares. Paisagens dunares geram anualmente um montante de R$ 800.428,46 por hectare (US$ 339,049.67). A maior contribui??o para esse montante econ?mico ? do parque visitado por turistas, em que o valor agregado pela recrea??o ? 53 vezes maior que o parque visitado por moradores. Embora turistas e moradores reconhe?am os benef?cios de alguns servi?os proporcionados por este ecossistema, ambos atribuem maior valor ? contempla??o da paisagem natural e ? recrea??o ao ar livre. A estimativa desse valor para os diferentes tipos de p?blico oferece ? gestores um justificativa econ?mica para direcionar uso e conserva??o de ?reas de dunas, subsidia na tomada de decis?o atrav?s de an?lises de custo benef?cio no processo de formula??o, acompanhamento e avalia??o de pol?ticas p?blicas e auxilia a investigar como os benef?cios variam de acordo com os tipos de visitantes. Portanto, o uso de estimativas do valor do meio ambiente nesta disserta??o, identificou o valor econ?mico intr?nseco das ?reas de dunas ?s ?reas naturais e o valor agregado pela sua exist?ncia e, portanto, permite que se dimensione a import?ncia dos investimentos em sua conserva??o e restaura??o, podendo ser utilizada como indicador para direcionar pol?ticas e distribui??o de investimentos para a conserva??o dos mesmos. Outro aspecto importante na aplicabilidade de metodologias de valora??o ambiental ? a contribui??o que o uso desse instrumento traz para o debate cient?fico sobre os problemas t?cnicos existentes nas metodologias

Made available in DSpace on 2014-07-29T14:49:13Z (GMT). No. of bitstreams: 1 Fernanda - IS RUR.pdf: 5926889 bytes, checksum: 700bff90e2c2f75c907320fa973aff3f (MD5) Previous issue date: 2009-09-25 / The valuation of family farming by Brazilian society constitutes an important tool for local development, since it uses scarce resources like land, labor force, efficiently. The rural homegardens are important production systems to complement other forms of land use, which besides providing food security for farmers, they perform functions aesthetic, recreational and conservation of local biodiversity. Thus, the study aimed to examine the total economic value (TEV) of the backyards of the universe of rural farmers involved in the Cooperative Family Farming of Itapuranga, noting its main economic functions, environmental and cultural. By means of the contingent valuation method, using the technique "payment card", tried to capture also the values of these non-market yards, as the perception and preferences of the farmers interviewed. Thus, 40 questionnaires were applied and visited 35 farms, where it was possible to observe directly the interaction of families with that environment. For economic functions, there was a survey of the main items (gross) consumed and sold during October 2007 and October 2008, reaching an average value of direct use of R$ 420.70 monthly. Other benefits from the yards were measured by DAP of the farmers interviewed, obtained by the MAC, with an average value of R $ 493.75 monthly. These values also correspond to the sociocultural aspects related to the tradition of those families where the woman responds by management and by the choices of crops, according to the tastes and habits of the family group. Regarding environmental aspects, the yards are considered important agroecological systems, since in most cases are not used chemical or toxic substances in their production. In recent years, faced with environmental problems in general, and the reopening of the sugarcane agro-industry in the city of Itapuranga, so does the importance of gardens as conservative biodiversity and balance of the fauna and flora. / A valorização da agricultura familiar pela sociedade brasileira constitui-se uma importante ferramenta de desenvolvimento local, uma vez que esta utiliza os recursos escassos, como a terra e a mão-de-obra, de forma eficiente. Os quintais rurais são importantes sistemas de produção complementar às outras formas de utilização da terra, que além de possibilitar a segurança alimentar dos agricultores familiares, desempenham funções estéticas, de lazer e de preservação da biodiversidade local. Dessa forma, o trabalho buscou analisar o valor econômico total (VET) dos quintais rurais do universo dos agricultores familiares associados à Cooperativa de Agricultura Familiar de Itapuranga, observando as suas principais funções econômicas, ambientais e culturais. Por meio do Método de Avaliação Contingente, utilizando a técnica cartão de pagamento , procurou-se captar também os valores de extramercado desses quintais, conforme a percepção e as preferências dos agricultores entrevistados. Com isso, foram aplicados 40 questionários e visitadas 35 propriedades rurais, onde foi possível observar diretamente a interação das famílias com esse ambiente. Para as funções econômicas, fez-se o levantamento dos principais itens (brutos) consumidos e vendidos durante outubro de 2007 e setembro de 2008, chegando-se a um valor médio de uso direto de R$ 420,70 mensais. Os demais benefícios provenientes dos quintais foram mensurados pela DAP dos agricultores entrevistados, obtida através do MAC, apresentando um valor médio de R$ 493,75 mensais. Esses valores correspondem também aos aspectos socioculturais ligados à tradição dessas famílias, onde a mulher responde pelo manejo e pelas escolhas dos cultivos, conforme os gostos e costumes do grupo familiar. Quanto aos aspectos ambientais, os quintais são considerados importantes sistemas agroecológicos, já que na maior parte das vezes não são utilizadas substâncias tóxicas ou químicas em sua produção. Nos últimos anos, frente à problemática ambiental de uma forma geral e com a reabertura da agroindústria canavieira no município de Itapuranga, cresce também a importância dos quintais enquanto conservador da biodiversidade e do equilíbrio da fauna e da flora local.