Université Paris Cité, LIRAES F-75006, 45 rue des Saints-Pères, 75006, Paris, France.
Université d'Angers, GRANEM, SFR Confluences, F-49000, Angers, France.
Eur J Health Econ. 2023 Feb;24(1):81-98. doi: 10.1007/s10198-022-01454-w. Epub 2022 Mar 19.
In this stated preferences study, we describe for the first time French citizens' preferences for various epidemic control measures, to inform longer-term strategies and future epidemics. We used a discrete choice experiment in a representative sample of 908 adults in November 2020 (before vaccination was available) to quantify the trade-off they were willing to make between restrictions on the social, cultural, and economic life, school closing, targeted lockdown of high-incidence areas, constraints to directly protect vulnerable persons (e.g., self-isolation), and measures to overcome the risk of hospital overload. The estimation of mixed logit models with correlated random effects shows that some trade-offs exist to avoid overload of hospitals and intensive care units, at the expense of stricter control measures with the potential to reduce individuals' welfare. The willingness to accept restrictions was shared to a large extent across subgroups according to age, gender, education, vulnerability to the COVID-19 epidemic, and other socio-demographic or economic variables. However, individuals who felt at greater risk from COVID-19, and individuals expressing high confidence in the governmental management of the health and economic crisis, more easily accepted all these restrictions. Finally, we compared the welfare impact of alternative strategies combining different epidemic control measures. Our results suggest that policies close to a targeted lockdown or with medically prescribed self-isolation were those satisfying the largest share of the population and achieving high gain in average welfare, while average welfare was maximized by the combination of all highly restrictive measures. This illustrates the difficulty in making preference-based decisions on restrictions.
在这项基于偏好的研究中，我们首次描述了法国公民对各种传染病控制措施的偏好，以便为长期战略和未来的传染病提供信息。我们在 2020 年 11 月（在疫苗接种可用之前）使用代表性样本中的 908 名成年人进行了离散选择实验，以量化他们愿意在社会、文化和经济生活限制、学校关闭、高发病率地区有针对性的封锁、直接保护弱势群体（如自我隔离）的限制以及克服医院超负荷风险的措施之间进行权衡。具有相关随机效应的混合对数模型的估计表明，为了避免医院和重症监护病房过载，存在一些权衡，这可能会降低个人的福利。根据年龄、性别、教育、对 COVID-19 流行的脆弱性以及其他社会人口统计学或经济变量，很大程度上可以在各亚组之间共享对限制的接受程度。然而，那些认为自己面临更大 COVID-19 风险的个体，以及对政府管理卫生和经济危机的信心较高的个体，更容易接受所有这些限制。最后，我们比较了结合不同传染病控制措施的替代策略的福利影响。我们的结果表明，接近有针对性的封锁或采用医学规定的自我隔离的政策是那些最能满足最大比例人群并实现平均福利高增长的政策，而所有高度限制措施的结合则使平均福利最大化。这说明了在限制方面做出基于偏好的决策的困难。
