It is standard practice to assume the discounted utility (DU) model on the part of the economic agents. This thesis tests the key axiom of the DU model (stationarity) in the health domain. Intertemporal preferences for health are of interest because of the debate over the appropriate treatment of future health effects in economic evaluation and of the relationship between intertemporal preferences and health-affecting behaviour. Social intertemporal preferences for fatal changes in health and private and social intertemporal preferences for non-fatal changes were elicited from members of the general public. Private intertemporal preferences for non-fatal changes were elicited from university students. Stationarity was violated in all three studies indicating that the DU model does not accurately describe individuals' intertemporal preferences. Psychologists dissatisfied with the DU model have developed hyperbolic models which replace the stationarity axiom by a generalised stationarity axiom. This thesis compared the descriptive properties of the DU model and hyperbolic discounting models in the health domain. The results showed that the hyperbolic discounting models fitted the data better than the DU model. This indicates that hyperbolic models should be preferred in the analyses of health affecting behaviour. Whether they should also be used in economic evaluations is likely to depend on other criteria as well as descriptive superiority. To inform the debate about the appropriate discount rate for health effects in economic evaluations this thesis investigated whether intertemporal preferences differ across outcomes within the health domain. The results showed that private and social intertemporal preferences for non-fatal changes in health are very similar. More differences were found between intertemporal preferences for fatal changes and non-fatal changes. This indicates that the debate over the relationship between individuals' preferences and the social discount rate is less important and that the debate should perhaps focus more on whether the rate should depend on the type of health outcome of the intervention.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:327044 |
| Date | January 2000 |
| Creators | Pol, Marjon van der |
| Publisher | University of Aberdeen |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU602020 |
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