Economics and the patient's utility function : an application to assist reproductive techniques
This thesis questions the assumption that health outcome is the only relevant argument in the patient's utility function. Following this, consideration is given to deciding which methods to use to establish what attributes there are in the patient's utility function and the relative weights to these attributes. Two methods are assessed and considered appropriate: contingent valuation and conjoint analysis. These methods are applied to assess the benefits from assisted reproductive techniques. An attempt is made to determine both the presence and relative importance of health and non-health attributes in the infertile person's utility function. The results from these empirical studies provide evidence of both the potential importance of factors beyond having a child and the sensitivity and applicability of the tools used to establish the relative importance of possible utility bearing attributes in the infertile person's utility function. The factors identified include: knowing you have done everything possible to have a child, the psychological feeling of disappointment, overall satisfaction with life following involvement with assisted reproductive techniques, the provision of follow-up support, and process type attributes such as continuity of care, attitudes of medical staff, waiting time and cost. Health economists concerned with developing economic instruments to measure utility from assisted reproductive techniques, and health care interventions more generally, should find the results useful. So too should those concerned with policy issues around the provision of assisted reproductive techniques and health care interventions more generally.