title: Demand assessment and price-elasticity estimation of quality-improved primary health care in Palestine: a contribution from the contingent valuation method.
abstract: This paper proposes a new methodology to assess demand and price-elasticity for health care, based on patients' stated willingness to pay (WTP) values for certain aspects of health care quality improvements. A conceptual analysis of how respondents consider contingent valuation (CV) questions allowed us to specify a probability density function of stated WTP values, and consequently, to model a demand function for quality-improved health care, using a parametric survival approach. The model was empirically estimated using a CV study intended to assess patients' values for improving the quality of primary health care (PHC) services in Palestine. A random sample of 499 individuals was interviewed following medical consultation in four PHC centers. Quality was assessed using a multi-attribute approach; and respondents valued seven specific quality improvements using a decomposed valuation scenario and a payment card elicitation technique. Our results suggest an inelastic demand at low user fees levels, and when the price-increase is accompanied with substantial quality-improvements. Nevertheless, demand becomes more and more elastic if user fees continue to rise. On the other hand, patients' reactions to price-increase turn out to depend on their level of income. Our results can be used to design successful health care financing strategies that include a consideration of patients' preferences and financial capacities.
authors.affiliation: French National Institute of Medical Research, Unit 379, France. awad@birzeit.edu
authors.forename: Awad
authors.initials: A
authors.lastname: Mataria
authors.forename: Stéphane
authors.initials: S
authors.lastname: Luchini
authors.forename: Yousef
authors.initials: Y
authors.lastname: Daoud
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Moatti
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D008877:Middle East; D017059:Models, Econometric; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000191:economics*; D011787:Quality of Health Care / Q000191:economics*; D012959:Socioeconomic Factors