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Econometric treatment of few protest responses in willingness-to-pay studies: An application in health care

Published online by Cambridge University Press:  09 January 2015

Nathalie Havet ,
Magali Morelle ,
Raphael Remonnay  and
Marie-Odile Carrere
Nathalie Havet
Affiliation:
GATE Lyon-Saint Etienne, University of Lyon, 93 chemin des Mouilles, 69 130 ECULLY, FRANCE (e-mail: Havet@gate.cnrs.fr)
Magali Morelle
Affiliation:
GATE Lyon-Saint Etienne, Léon Bérard Comprehensive Cancer Center, 28 rue Laënnec, 69373 LYON Cedex 08, FRANCE (e-mail: morelle@lyon.fnclcc.fr, raphael_remonnay@sfr.fr, mo.carrere@wanadoo.fr)
Raphael Remonnay
Affiliation:
GATE Lyon-Saint Etienne, Léon Bérard Comprehensive Cancer Center, 28 rue Laënnec, 69373 LYON Cedex 08, FRANCE (e-mail: morelle@lyon.fnclcc.fr, raphael_remonnay@sfr.fr, mo.carrere@wanadoo.fr)
Marie-Odile Carrere
Affiliation:
GATE Lyon-Saint Etienne, Léon Bérard Comprehensive Cancer Center, 28 rue Laënnec, 69373 LYON Cedex 08, FRANCE (e-mail: morelle@lyon.fnclcc.fr, raphael_remonnay@sfr.fr, mo.carrere@wanadoo.fr)
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Summary

In contingent valuation surveys, there is a range of possible explanations for zero bids, from true zero responses consistent with economic decisions to protest responses. According to the empirical literature, which analyzes the determinants of willingness-to-pay (WTP) values from a bidding process, the double-hurdle is the most appropriate econometric approach to account for zero and protest WTP. However, when the number of protest responses is too small to be explicitly modelled, this approach is not applicable. This frequently occurs in critical health care situations, where large samples are not easily available. We discuss the possible econometric strategies for use in such cases. For illustrative purposes, the different models were applied to an empirical situation, which refers to the location preference (i.e. home versus hospital) from French cancer patients for blood transfusion. Our results show that protest responses should not be discarded, even if present in small numbers, and that the type II Tobit and the standard truncated regression model could both be applied. However, since from small finite samples, the most robust estimation is obtained from the bootstrap method with a high number of replications, the truncated regression model, easily applicable, weakly computer time-consuming and not subject to identification problems in this case contrary to the type II Tobit, should be the econometric strategy of choice for various WTP studies in the healthcare field.

Dans les études d'évaluation contingente, de nombreuses réponses correspondent à des dispositions à payer nulles (DAP), mais avec des justifications fort différentes, qui vont des vraies réponses nulles cohérentes avec les décisions économiques aux réponses protestataires. La littérature empirique portant sur les déterminants des DAP issues d'enchères a mis en évidence que le modèle “double-hurdle” était le plus approprié pour tenir compte du double caractère de ces réponses nulles. Cependant, quand le nombre de réponses protestataires est trop faible pour être explicitement modélisé, cette approche n'est pas applicable. Ce papier discute des stratégies économétriques possibles dans de tels cas, fréquents dans les études de soins de santé. Les différents modèles envisagés sont appliqués à l'étude des déterminants des DAP, de patients français atteints du cancer, pour la transfusion sanguine à domicile. Nos résultats montrent que les réponses protestataires ne doivent pas être éliminées, même si elles sont en nombre limité, et que le Tobit type II et le modèle stan¬dard de régression tronquée peuvent tous les deux être appliqués. Toutefois, comme sur échantillons finis de petite taille, la méthode d'estimation la plus robuste est celle du bootstrap avec un grand nombre de réplications, le modèle tronqué, facilement applicable, économe en temps de calcul et non sujet aux problèmes d'identification dans ce cas contrairement au Tobit type II, est un modèle économétrique qui pourrait être privilégié dans de nombreuses études de DAP en économie de la santé.

Keywords

protest responseseconometric specificationscontingent valuationhome care118C13C24réponses protestatairesmodélisations économétriquessoins à domicileévaluation contingente118C13C24
Type
Research Article
Information
Recherches Économiques de Louvain/ Louvain Economic Review , Volume 78 , Issue 2 , June 2012 , pp. 53 - 74
Copyright
Copyright © Université catholique de Louvain, Institut de recherches économiques et sociales 2012 

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