Aas Eline
Institute of Health Management and Health Economics, University of Oslo, Oslo, Norway.
Health Econ. 2009 Mar;18(3):337-54. doi: 10.1002/hec.1371.
The participation rate in medical screening programmes is typically below 100%, which means that not all potential health benefits are fully exploited. In this paper, the prospect of pecuniary compensation is tested as a method of increasing the participation rate. We propose a model explaining the individual's probability of participating in screening for colorectal cancer when he is offered pecuniary compensation, given that he did not participate when first invited. The participant's decision is based on both known and uncertain factors. The estimation is conducted in two steps, where a binary probit model is used in each. We find that pecuniary compensation increases the probability of participation, and that an individual's participation probability systematically varies with variables such as travel expenses, income, age, education level, expected benefit from the screening, use of health-care services, genetic predisposition and subjective health status. Using the results from the estimation, we predict changes in the participation rate for different levels of compensation and estimate the cost per additional individual screened. The cost per additional individual screened is 808, including 25 in compensation; this cost increases with the level of compensation.
医学筛查项目的参与率通常低于100%，这意味着并非所有潜在的健康益处都能得到充分利用。在本文中，对金钱补偿前景作为提高参与率的一种方法进行了测试。我们提出了一个模型，用于解释个人在首次被邀请时未参与，而在获得金钱补偿后参与结直肠癌筛查的概率。参与者的决策基于已知和不确定因素。估计分两步进行，每一步都使用二元概率模型。我们发现金钱补偿会增加参与概率，并且个人的参与概率会随着诸如差旅费、收入、年龄、教育水平、筛查预期收益、医疗服务使用情况、遗传易感性和主观健康状况等变量而系统地变化。利用估计结果，我们预测了不同补偿水平下的参与率变化，并估计了每多筛查一名个体的成本。每多筛查一名个体的成本为808，其中补偿为25；此成本会随着补偿水平的提高而增加。
