Objective: To understand the different methodologies used to elicit willingness to pay for health and the value of a statistical life year through blogger.comology: A systematic review of the literature was undertaken to identify studies using surveys to estimate either willingness to pay for health or the value of a statistical life blogger.com study was reviewed and the study setting The high speed of Qaz Literature Review On Willingness To Pay writing is one of the superpowers our experts have. No matter how urgent the deadline of your paper can be, you will get it on time. Just make sure to set realistic deadlines as our employees do not have magic wands yet/10() The purpose of this report is to review the potential value to Maryland residents of environmental improvements resulting from the implementation of stormwater projects. We conducted a literature review and economic valuation to estimate annual willingness to pay (WTP) values for Maryland
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For more information about PLOS Subject Areas, literature review on willingness to pay, click here. Access to healthcare is mostly contingent on out-of-pocket spending OOPS by health seekers, particularly in low- and middle-income countries LMICs. This would require many LMICs to raise enough funds to achieve universal health insurance coverage, literature review on willingness to pay.
But, are individuals or households willing to pay for health insurance, and how much? What factors positively affect WTP for health insurance? We wanted to examine the evidence for this, through a review of the literature. We systematically searched databases up to February and included studies of individual or household WTP for health insurance. Two authors appraised the identified studies.
We estimated the WTP as a percentage of GDP per capita, and adjusted net national income per capita of each country. We used meta-analysis to calculate WTP means and confidence intervals, and vote-counting to identify the variables that more often affected WTP. The mean WTP of individuals was 1. The corresponding figures for households were 1. Increases in family size, education level and income were consistently correlated with higher WTP for insurance, and increases in age were correlated with reduced WTP.
The findings demonstrate that in moving towards universal health coverage in LMICs, governments should not rely on households' premiums as a major financing source and should increase their fiscal capacity for an equitable health care system using other sources. Citation: Nosratnejad S, Rashidian A, Dror DM Systematic Review of Willingness to Pay for Health Insurance in Low and Middle Income Countries.
PLoS ONE 11 6 : e Editor: Ulla Kou Griffiths, London School of Hygiene and Tropical Medicine, UNITED KINGDOM. Received: November 13, ; Accepted: May 30, ; Published: June 30, Copyright: © Nosratnejad et al. This is an open access article distributed under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Competing interests: The authors have declared that no competing interests exist. The interest in Willingness To Pay WTP for health insurance arises in settings where on the one hand access to healthcare is mostly contingent on Out-Of-Pocket Spending OOPS by health seekers, and on the other hand health insurance schemes must know upfront how much they could charge as premium, to ensure their financial sustainability.
This framing would require many LMICs to raise enough funds to achieve universal health insurance literature review on willingness to pay. This poses a number of questions: are individuals or households willing to pay for health insurance, and how much?
And is the role of governments obviated when private health insurance is offered? This study focuses on reviewing the evidence about WTP for social or other non-commercial health insurance including community-based mutual health insurance with the view to offer policymakers an estimate of the resources that literature review on willingness to pay be generated from uninsured population segments were health insurance offered, based on the evidence from pilot experiments reported in the existing literature from low- and middle income countries.
RP is a predictive, modeling approach to WTP, based on studying actual purchasing behavior of products from which we wish to estimate the WTP for the product for which no purchasing information exists and that we are interested in. Unfortunately, we could not find any published study using the RP method to estimate WTP for health insurance in LMIC. The alternative option, SP, is to ask people what they would be willing to pay for insurance cover that they do not yet have, and that is perhaps not even on the market.
Several SP methods evolved to value non-market goods. Respondents are required to think about the contingency or feasibility of an actual market for the benefits, and state the maximum they would be willing to pay for them. This method assumes that prospective clients are given a detailed description of the product for which they are asked how much they would be willing to pay.
However, if the price determines the product, and is not yet known, how then is it possible to guarantee that the described product would actually be the one delivered? WTP is presumably mediated by ability to pay and by individual and cultural aspects that determine how the utility of insurance is perceived.
Different authors have used different anchors to measure the WTP against e. income, disposable income, food expenditure etc. In the interest of comparison across countries and different socioeconomic contexts, we propose to assess WTP levels against per capita GDP, literature review on willingness to pay.
This article is structured as follows: section 2 contains methodological notes. Results of the review are presented in Section 3, and a discussion and conclusions in the 4 th and last section.
Literature review on willingness to pay literature search conducted in February included academic and gray literature. The academic thematic databases included Pubmed, Science Direct and Scopus and search engine of Google scholar.
The gray literature was searched manually, through citation tracking. Search strategies for electronic databases were developed by one of the authors SN and peer-reviewed by other authors. One of the authors conducted the search. The search identified studies published until Primary studies that assessed households or individuals' WTP for health insurance in LMIC were eligible for inclusion.
Studies were considered eligible for inclusion if:. These selection criteria meant that studies that focused solely on insurance of other risks, or health insurance that was based on individual risk rating and without any aspect of community rating for the purpose of defining the level of payment requested from the individual e.
private actuarial insurance were not eligible for inclusion. Finally, studies that assessed WTP for certain health care services e. insurance for dental care or complementary inpatient insurance were not eligible for literature review on willingness to pay. A priori, we considered any previously published systematic review studies of WTP for health insurance as eligible for inclusion in this review, if they answered the same questions.
No other article adopted the exact same inclusion criteria; we found one study on the same topic which did not expressly exclude private health insurance but was also focused in LMIC, where private health insurance is rare[ 5 ]. Those articles retained 13 articles within the date range from toof which 12 are also included in this systematic review; this review includes 11 additional studies for a total of 23 articles. And its analysis followed a different method[ 5 ].
Hence, we do not literature review on willingness to pay a previous study to which we can compare our results. One author extracted data from included studies and entered them into the data extraction sheet that was then checked by another author for accuracy and completeness.
Data extracted included location and year of study, sample size, response rate, target population, household size, data collection method, variables that significantly affected WTP, and WTP values per individual and per household reported in the study. Additionally, we collected data on country specific Gross Domestic Product GDP per capita, net national income and population in the year of the study from the World Bank's list of indicators[ 6 ].
The titles and the abstracts of identified papers were screened, and those that were obviously unrelated to our review were excluded. The included studies in this meta-analysis reported WTP values. If not reported, we used the International Monetary Fund IMF values [ 10 ]. In the next step, literature review on willingness to pay, we literature review on willingness to pay the WTP of individuals or households as a percentage of GDP per capita and as a percentage of adjusted net national income per capita of each country.
Standard error SE of the effect size was estimated from the SE of the WTP values by applying similar transformation used for estimating the effect size. Some authors reported the 95 percent confidence intervals instead of the SE. For these studies we first computed the SE of the values and then computed the SE of the effect size by using the following way. Some authors did not report the SE, CI Class Interval.
Therefore, we could not estimate the SE of the effect size for these studies [ 11 — 13 ]. The standard practice in meta-analysis is to apply weights proportional to the variances of the effect size for estimating the summary effect. In this meta-analysis we applied the SEs of the effect size as a weight. When a WTP values were computed in the same way by all studies, the summary effect was obtained by averaging the effect sizes, after applying weights. We used fixed and random effect meta-analysis techniques to calculate summary effect, based on the level of heterogeneity between the included studies.
A descriptive vote-counting approach conducted with literature review on willingness to pay as follows [ 1415 ]:. We follow the PRISMA approach in performing this systematic review, and we attached the PRISMA form as appendix S1 Appendix.
Our academic database searches yielded hits and the gray literature searches another 8 articles. After screenings of the titles and abstracts, we kept58 studies for full-text review Fig 1and thereafter retained 23 articles for detailed review [ 11 — 1316 — 35 ]. Of these, two articles literature review on willingness to pay 26 ] and [ 20 ] were excluded after quality assessment. The remaining 21 articles relate to 16 distinct studies literature review on willingness to pay the following ten countries: In Asia: Bangladesh [ 34 ], China [ 27 ], India [ 18192833 ], Iran [ 2132 ] and Vietnam [ 12 ].
In Sub- Saharan African: Burkina Faso [ 16 ], Cameroon [ 22literature review on willingness to pay, 30 ], Ethiopia [ 13 ], Ghana [ 11 ], and Nigeria [ 1729 ]. The studies altogether had surveyed about households plus about individuals. Consequently, in Table 1 we included 17 studies as the study of the scheme in Burkina Faso is considered by reference to two articles by Dong et al one relating to households and the other to individual WTP in the same scheme.
In Table 2we only listed the 12 out of literature review on willingness to pay distinct studies which had adequate data for Meta-analysis. And in Table 3 we list only 16 studies, since the variables under consideration allowed considering Burkina Faso as a single study. Details of the quality of studies are presented in appendix S2 Appendix. The overall methodological quality of included empirical studies was good, with more than half of studies meeting all criteria.
Two studies [ 2026 ] that did not rank suitably according to this appraisal were excluded from further analysis, literature review on willingness to pay. The sample sizes of the studies varied greatly, from to 3, individuals. Seven studies were conducted in rural settings[ 12131921222930 ], four studies on rural and urban residents [ 11161728 ], one study on urban residents [ 32 ], three studies on urban informal sector employees [ 273334 ] and one study on the urban poor [ 18 ].
Most of the studies involved face-to-face interviews with the respondents, literature review on willingness to pay. All of literature review on willingness to pay identified studies used contingent valuation for WTP estimation: bidding game eightopen ended fivedouble-bounded fivepayment cards two and single bounded one methods, including four studies that used more than one method.
We were able to calculate the WTP as percentages of GDP and net national income per capita for all except one included study; that one exception estimated the WTP only as a percentage of household income and did not report monetary values[ 18 ]. Four studies that measured household WTP provided enough data to enable us to calculate the corresponding individual WTP[ 11121929 ].
Out of 15 studies, ten studies provided enough data to conduct a meta-analysis of WTP at individual level, using national GDP data: 1. Out of five studies, four studies provided enough data to conduct a meta-analysis of WTP at household level: 1. All the meta-analysis resulted in small p-values suggesting that the findings were unlikely to have occurred due to chance, noting the studies were conducted in different times and different countries.
We repeated the analyses after excluding the studies conducted in urban areas that reported substantially higher WTPs, but this did not affect the meta-analysis results, literature review on willingness to pay. We categorized all objective variables that were assessed for their influence on WTP for health insurance into five groups, as follows:. Our study is the first systematic review of WTP of individuals or households for health insurance in LMICs.
Our study had two main objectives that we discuss in turn: identifying the variables that consistently affected WTP for insurance in different settings, and a transferrable estimation of the level of WTP in LMICs as a percentage of GDP or net income per capita.
Literature Reviews: Common Errors Made When Conducting a Literature Review
, time: 12:23Understanding the global measurement of willingness to pay in health
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