This study is part of a programme to elicit and examine community preferences for health care in different contexts. Data were obtained from a group of predominantly Australian health care decision-makers. A short questionnaire contained six valuation questions and four demographic questions. The six valuation questions posed choices where equal health gains were to be allocated to different population groups based upon: age; sex; current health; socio-economic status; across time; and across different numbers of individuals. The results provide some evidence (...) that respondents were prepared to discriminate between health gains derived in different contexts especially where health gains were to be allocated between groups of different health status and over time. Further research is planned and the possible implications for health policy, and in particular for resource allocation in health care, are briefly discussed. (shrink)

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Most of the debate surrounding standards in medical care, issues of medical audit and what constitutes benefit from health care assumes that what is obtained from health care is health and only that. This is an assumption which most health economists at least implicitly appear to endorse. This paper questions that assumption. There are various outcomes beyond health and there are various processes involved in health care about which patients are not indifferent. This paper calls for a fuller investigation as (...) to what it is that patients want from their health services and the adoption of a more pluralistic conception of health care benefits. It is further argued that the objectives of health care systems are those in which citizensqua citizens also have interests and which may be different from those of patients. It is yet less likely that citizens’ interests in health care will be restricted to health. (shrink)

In most forms of evaluation the benefits of preventive health care are narrowly defined in terms of reductions in future morbidity and mortality. Thus it is normally assumed that it is the final health gains alone which bear utility. This discounts the possibility that individuals may derive utility from the process of health care and other outcomes as well as the end health states. Attributes such as anxiety, reassurance, autonomy, regret and hope provide potential benefits or disbenefits in addition to (...) health gains. This paper explores the concept of process utility in the specific context of preventive goods. Characteristics such as information, awareness and autonomy are examined for two preventive goods—hip protectors and mammographic screening. If individuals trade off process attributes for final health outcomes, then to ignore process utility may lead to a sub-optimal allocation of resources. (shrink)