Open Access
Incentives when altruism is impure: the case of blood and living organ donations
(2013) Errea Rodríguez, María; Cabasés Hita, Juan Manuel; Economía; Ekonomia
The decision to donate blood and living organs is considered voluntary and altruistic. However, the shortage of donors has opened an interesting debate in recent years, considering offering economic incentives to donors. This paper analyzes theoretically and empirically, the effects of incentives over individuals when facing the decision of becoming donors. Results show that crowding-in of blood donors would be more likely by offering 'Information concerning blood donations' or 'Blood Tests'. In both, blood and living organ donations, 'Money' would be very likely to crowd-out individuals from donating. Concerning living organs, we do not find good evidence for crowding-in. We conclude donation policies, properly designed, could help to increase the number of donors, and more specifically suggest implementing non-monetary incentives.
Open Access
Comparing the psychometric properties of the EQ-5D-5L between mental and somatic chronic patients populations
(2013) Cabasés Hita, Juan Manuel; Errea Rodríguez, María; Hernández Arenaz, Íñigo; Economía; Ekonomia
The validity and reliability of the EQ-5D-5L in comparison with the standard 3L has been tested through the analysis of psychometric properties making use of different samples of patients. However, it is likely that the condition of the illness may affect the power of the 5L version with respect to the 3L one. Here we report on parallel testing of EQ-5D-5L and 3L administered to a sample of chronic patients of both somatic and mental illness. The aim of this study is to check some psychometric properties in both subsamples. Methods: We check for the usual psychometric properties: feasibility, (in)consistency, ordinality (and transitivity), informativity, face validity and convergent validity. Also, we perform new analysis for checking transitivity and the Cronbach-? for convergent validity. Finally, we proposed a complementary way for looking at the property of informativity through three different indexes (effective, absolute and overall) based on the statistical discriminatory power. Data: We have a total of 1002 questionnaires finally collected. 444 (46.25%) chronic mental patients, 516 (53.75%) have somatic chronic illnesses; 42 observations of unknown origin of the illness have been dropped to perform this analysis. Results: The mean value reported in the VAS for the full sample is 60.93. Somatic patients report a mean of 64.42 points in this scale and mental patients report 56.83 points in the VAS. Analyzing the distribution of the responses to problems on each dimension we found, for all cases, a highly skewed distribution. Moreover, the distribution of responses changes significantly between subsamples, as expected. In all dimensions, it seems that somatic patients take more advantage of the extra levels introduced by the EQ-5D-5L. This group reduces to a greater extent the missing response rate, commit less (and of lower importance) inconsistencies, get a higher correlation of the 5L scale and the VAS within the 3L levels, complements better the dimensions to get an overall score (measured through the Cronbach’s alpha), reduces in a more significant way the “no problem” response and the Informativity gain is also superior (for both the Shannon Evenness Index and our Absolute Index). This higher performance of the EQ-5D-5L on somatic patients is endorsed by a higher preference of somatic patients toward the 5L version of the questionnaire than to the 3L one. Conclusion: Results show the suitability of the 5L version in both subsamples, but it is much more effective for somatic patients. These subsamples’ differences may be of concern when aggregating and comparing different data.
Open Access
Valuing health using EQ-5D: the impact of chronic diseases on the stock of health
(Wiley, 2019) Sánchez Iriso, Eduardo; Errea Rodríguez, María; Cabasés Hita, Juan Manuel; Ekonomia; Institute for Advanced Research in Business and Economics - INARBE; Economía
Chronic diseases strongly affect individuals' health status. In aggregate terms, this impact is reflected by the stock of health, which measures the amount of health of a population in a given period of time. The objectives of this study were to measure the relative burden of chronic illnesses by assessing health-related quality of life using the EQ-5D-5L instrument, to rank diseases according to their associations with the stock of health, and to calculate the stock of health of the Spanish population and the amount of health loss attributable to each chronic disease from a social perspective. Data were gathered from the Spanish Health Survey (ENSE 2011–2012, N = 20,587). A population weighted least squares model was used. Chronic diseases represent 19.19% of the stock of health losses in Spain compared with a country free from those diseases. In Spain, the stock of health in 2011 was 31.86 million units on the visual analog scale. The diseases with the strongest impact in terms of loss of stock of health at the individual level were mental illness and embolism, stroke, or cerebral hemorrhage. Collectively, the diseases with the largest impact included osteoarthritis, arthritis, or rheumatism; chronic back pain; and high blood pressure.
Open Access
Encouraging blood and living organ donations
(2014) Errea Rodríguez, María; Cabasés Hita, Juan Manuel; Economía; Ekonomia
This thesis explores the decision of becoing blood and living organ donors. Theoretical and empirical approaches are provided. The first two chapters develop a theoretical behavioral model that helps to disentangle the psychology behind the decision of individuals of becoming blood and living organ donors. The model emphasizes the importance of altruism and warm-glow, and how introducing incentives could undermine the individuals' degree of altruism. A questionnaire is also designed in order to explore in the real population attitudes towards blood and living organ donations. The third chapter is an entirely empirical work and focus on blood donation. Data from the National Health Survey of France (ESPS 2012) are analyzed, focusing on exploring the population of blood donors and the influence of altruism, socio-economic status, social capital and risk aversion. The fourth chapter is focused on policy evaluation. Specifically it analyzes the impact of blood donation campaigns implemented in the spanish region of Navarra since 2010.
Open Access
Attitudes towards blood and living organ donations
(2010) Cabasés Hita, Juan Manuel; Errea Rodríguez, María; Economía; Ekonomia
We model the decision of whether or not to become a blood/living organ donor. The expected utility for becoming a donor is a function of the degree of altruism, the consumption of goods, the costs of donation, the very pleasure of giving, and the recipient’s utility associated to donation. Empirically, we observe differences in the expected costs and benefits from donation between blood and non-blood donors, and between individuals with different willingness to donate living organs. Looking at benefits/costs of donation through reasons for donating/not donating, we conclude policies to encourage donation should focus on raising awareness and provide information.
Open Access
EQIS 1.0 user guide
(2011) Sánchez Iriso, Eduardo; Errea Rodríguez, María; Economía; Ekonomia
Where is QALY? The search of values for QALYs (Quality Adjusted Life Years) in the field of Health Economics is not easy. Economic Evaluations, particularly cost-utility analysis, should be of standard practice, but the tools to implement them are rare and require of specific expertise. In many occasions, colleagues approached to us to ask for measures of effectiveness that are used, and show interest in how to obtain it. Such a motivation has led us to generate EQIS 1.0, the friendly software that allows calculating Health Related Quality of Life weights. The following pages introduce EQIS 1.0, and are thought for a quick start using the software. Please do not hesitate to contact the authors for comments, suggestions or any problem you find in the program.