Diener A, O'Brien B, Gafni A
Department of Economics, McMaster University, Hamilton, Ontario, Canada.
Health Econ. 1998 Jun;7(4):313-26. doi: 10.1002/(sici)1099-1050(199806)7:4<313::aid-hec350>3.0.co;2-b.
The contingent valuation method (CVM) is a survey-based approach for eliciting consumer's monetary valuations for programme benefits for use in cost-benefit analysis (CBA). We used the conceptual framework of O'Brien and Gafni (1996) to classify and critically appraise health care CVM studies.
Search of computerized health care and economic citation databases (e.g. MEDLINE, ECONLIT) and manual search for papers published between 1984 1996 reporting primary data valuing health programme benefits in monetary units by CVM using willingness-to-pay (WTP) or accept (WTA). We classified studies using both empirical (i.e. who was surveyed and how) and conceptual criteria (i.e. which measure of consumer utility was measured and why).
48 CVM studies were retrieved; the majority (42) undertook money valuation in the context of cost benefit analysis (CBA), with the remainder being pricing/demand studies. Among the 42 CBA studies, the consumer utility being measured (i.e. compensating (CV) vs. equivalent variation (EV) was explicitly stated in only three (7%) studies). WTP was measured in 95% of studies and WTA in 5%. By cross-tabulation, 42 (91%) studies were designed as WTP/CV, two (4%) were WTP/EV, two (4%) were WTA/CV and no studies used WTA/EV. Most studies were administered by mail (52%) with 38% being in-person interviews. Value elicitation techniques included open-ended questions (38%), payment cards (19%) discrete choice questions (26%) or bidding games (29%). Some form of construct validation tests, particularly associations between WTP and income, were done in 21 studies (50%).
(i) The number of health care CVM studies is growing rapidly and the majority are done in the context of CBA; (ii) there is wide variation among health care CVM studies in terms of the types of questions being posed and the elicitation formats being used; (iii) classification and appraisal of the literature is difficult because reporting of methods and their relationship with the conceptual framework of CBA is poor; (iii) the applicability to health care of the CVM guidelines issued by the National Oceanic and Atmospheric Administration (NOAA) panel for environmental economics is unclear.
条件价值评估法（CVM）是一种基于调查的方法，用于获取消费者对项目效益的货币估值，以用于成本效益分析（CBA）。我们使用奥布赖恩和加夫尼（1996）的概念框架对医疗保健CVM研究进行分类和批判性评估。
检索计算机化的医疗保健和经济文献数据库（如MEDLINE、ECONLIT），并手动搜索1984年至1996年间发表的论文，这些论文报告了使用意愿支付法（WTP）或接受法（WTA）以货币单位对健康项目效益进行估值的原始数据。我们使用实证标准（即调查对象和调查方式）和概念标准（即衡量的消费者效用指标及原因）对研究进行分类。
共检索到48项CVM研究；大多数（42项）是在成本效益分析（CBA）背景下进行货币估值，其余为定价/需求研究。在42项CBA研究中，仅3项（7%）明确说明了所衡量的消费者效用（即补偿变差（CV）与等价变差（EV））。95%的研究测量了WTP，5%测量了WTA。通过交叉列表分析，42项（91%）研究设计为WTP/CV，2项（4%）为WTP/EV，2项（4%）为WTA/CV，没有研究使用WTA/EV。大多数研究通过邮寄方式进行（52%），38%为面对面访谈。价值诱导技术包括开放式问题（38%）、支付卡（19%）、离散选择问题（26%）或投标博弈（29%）。21项研究（50%）进行了某种形式的结构效度测试，特别是WTP与收入之间的关联。
（i）医疗保健CVM研究数量迅速增长，且大多数是在CBA背景下进行的；（ii）医疗保健CVM研究在提出的问题类型和使用的诱导形式方面存在很大差异；（iii）由于方法报告及其与CBA概念框架的关系不佳，对文献进行分类和评估很困难；（iii）美国国家海洋和大气管理局（NOAA）环境经济学小组发布的CVM指南对医疗保健的适用性尚不清楚。
