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Quality of life of alcohol-related diseases and road accidents in Switzerland: An economic assessment France Priez The University of North Carolina at Chapel Hill Neuchâtel October 24th 2003
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Social cost of substance abuse Economic costs Direct costs Indirect costs Quality of life Burden for the society resulting from substance abuse and expressed in monetary units
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Quality of life and alcohol abuse Impact on health e.g. Road accidents Diseases Impact on behavior e.g. Drunkeness Addiction
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Impact of accidents and diseases on quality of life Physical consequences Psychological impact Changes in life style Loss of life (if death)
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Selection of diseases
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How to measure quality of life Survey Ask participants to tell what is their quality of life with specific accidents or diseases Monetary measure = human costs Willingness to pay to avoid accident or disease Scale = utility index Full health = 1, Death = 0, Specific condition = ?
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Methods Welfare Economics Expressed preferences 1.Contingent valuation 2.Standard gamble
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Contingent Valuation Only for ENT cancer and hypertension (+ road accidents from former study) Describe health condition and main risk factors Present the average risk of suffering from such condition by gender Contingent market: How much are you willing to pay to reduce your risk of suffering from such disease or having such accident
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Standard Gamble For ENT cancer, hypertension, liver cirrhosis and chronic pancreatic Quality of life measured by a utility index between 1 (full health) and 0 (death) Death Full health No treatment = Health condition Treatment p 1- p Decision
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Methodological decisions Selection and description of diseases Pre-tests, in-depth interviews Target population: general population Health as private good Ex-ante estimation Sensitivity analysis: risk variations of 95% & 50% Face-to-face interview Quotas sampling
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Two-step estimation 1 st step (ENT cancer and hypertension) Contingent valuation and standard gamble Human costs = - f [ utility index ] 2 nd step (liver cirrhosis and chronic pancreatic) Standard gamble only Plug utility index in above function to get human costs
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Quota sampling Reasons: face-to-face interviews & visual cards Representative sample of Swiss population 18+ Four quotas: – Gender – Rural versus urban – Age group – Socio-economic category
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Sample sizes
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Mean utility index of alcohol-related diseases
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Mean human costs of alcohol-related diseases
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Total human costs of alcohol-related diseases and road accidents in Switzerland in 1998 Economic costs2,191.7
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The End
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Sample characteristics
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Contingent Valuation (2) Advantages – Theoretical foundations – Flexible – Price of non-market goods Disadvantages –‘Fictive’ market – Potential biases – Potentially all costs faced by individuals
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Standard Gamble (2) Advantages – Theoretical foundations – Measures quality of life only – No direct link with income Disadvantages –‘Fictive’ market – Potential biases – No direct monetary value
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Utility index and human costs of alcohol-related diseases
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Alcohol-related road accidents in Switzerland in 1998
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