Polynomics AG, Olten, Switzerland; University of Zurich, Switzerland.
Polynomics AG, Olten, Switzerland; University of Lucerne, Switzerland.
J Health Econ. 2018 Jul;60:30-38. doi: 10.1016/j.jhealeco.2018.06.001. Epub 2018 Jun 7.
Healthcare expenditure (HCE) spent during an individual's last year of life accounts for a high share of lifetime HCE. This finding is puzzling because an investment in health is unlikely to have a sufficiently long payback period. However, Becker et al. (2007) and Philipson et al. (2010) have advanced a theory designed to explain high willingness to pay (WTP) for an extension of life close to its end. Their testable implications are complemented by the concept of 'pain of risk bearing' introduced by Eeckhoudt and Schlesinger (2006). They are tested using a discrete choice experiment performed in 2014, involving 1,529 Swiss adults. An individual setting where the price attribute is substantial out-of-pocket payment for a novel drug for treatment of terminal cancer is distinguished from a societal one, where it is an increase in contributions to social health insurance. Most of the economic predictions receive empirical support.
在个人生命的最后一年中花费的医疗保健支出（HCE）占一生 HCE 的很大一部分。这一发现令人费解，因为对健康的投资不太可能有足够长的回报期。然而，Becker 等人（2007 年）和 Philipson 等人（2010 年）提出了一种旨在解释接近生命终点时对延长生命的高支付意愿（WTP）的理论。他们的可检验含义得到了 Eeckhoudt 和 Schlesinger（2006 年）提出的“风险承担痛苦”概念的补充。这些理论是使用 2014 年进行的一项离散选择实验来检验的，该实验涉及 1529 名瑞士成年人。一个个体设置，其中价格属性是为治疗晚期癌症的新型药物支付大量自付费用，与社会设置不同，社会设置是增加对社会健康保险的缴款。大多数经济预测都得到了实证支持。
