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避免癌症(或死于癌症)的好处:来自四国研究的证据。

The benefits of avoiding cancer (or dying from cancer): Evidence from a four- country study.

机构信息

AREC, 2200 Symons Hall, University of Maryland, College Park, MD 20742, United States.

Charles University Environment Center, Prague, Czech Republic.

出版信息

J Health Econ. 2018 Jan;57:249-262. doi: 10.1016/j.jhealeco.2017.08.004. Epub 2017 Aug 19.

Abstract

We use stated-preference methods to estimate the cancer Value per Statistical Life (VSL) and Value per Statistical Case (VSCC) from a representative sample of 45-60-year olds in four countries in Europe. We ask respondents to report information about their willingness to pay for health risk reductions that are different from those used in earlier valuation work because they are comprised of two probabilities-that of getting cancer, and that of dying from it (conditional on getting it in the first place). The product of these two probabilities is the unconditional cancer mortality risk. Our hypothetical risk reductions also include two severity-related attributes-quality-of-life impacts and pain. The results show that respondents did appear to have an intuitive grasp of compound probabilities, and took into account each component of the unconditional cancer mortality risk when answering the valuation questions. We estimate the cancer VSL to be between approximately € 2 and 5.950 million, depending on whether the (unconditional) mortality risk was reduced by lowering the chance of getting cancer, increasing the chance of surviving cancer, or both. The VSCC is estimated to be up to € 0.578 million euro, and its magnitude depends on the initial (conditional) cancer mortality and on the improvement in survival. The survey responses show that our measures of cancer severity-impacts on daily activities and pain-have little or no effect on the WTP to reduce the adverse health risks.

摘要

我们使用陈述偏好方法来估计癌症的每统计生命价值(VSL)和每统计病例价值(VSCC),样本来自欧洲四个国家的 45 至 60 岁人群。我们要求受访者报告有关其对健康风险降低的支付意愿的信息,这些风险与早期估值工作中使用的风险不同,因为它们包含两个概率——患癌症的概率和因癌症死亡的概率(前提是首先患上癌症)。这两个概率的乘积是无条件癌症死亡率风险。我们假设的风险降低还包括两个与严重程度相关的属性——生活质量影响和疼痛。结果表明,受访者似乎确实对复合概率有直观的理解,并在回答估值问题时考虑了无条件癌症死亡率风险的每个组成部分。我们估计癌症 VSL 在 200 万至 595 万欧元之间,具体取决于通过降低患癌症的机会、增加癌症存活的机会还是同时降低两者来降低(无条件)死亡率风险。VSCC 估计高达 57.8 万欧元,其大小取决于初始(条件)癌症死亡率和生存状况的改善。调查回应表明,我们对癌症严重程度的衡量标准——对日常活动和疼痛的影响——对降低不利健康风险的支付意愿几乎没有影响。

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