On the Estimation of QALD (Quality Adjusted Life Days) based on Expenditure Data for Childbirth and Maternity Services in India using Utility Theory
Objectives: Quality-Adjusted-Life Years (QALY)helps to measure health outcome for a particular health state. This study redefines QALY by working on the expenditure function incurred in deliveries for private and public hospitals.
Methods/ Statistical Analysis: Data has been taken from the NSS 71st round ‘Health in India’ (January – June 2014). Utility functions have been estimated by fitting the polynomial of different degrees and then marginal rate is computed. This utility function is estimated using multiplicative and logarithmic form. Also, utility functions are constructed from the method given by Afriat (1964). Further, QALD’s are computed for different quintiles based on usual monthly per capita expenditure.
Findings: Through this data we examine the health outcome which is found to be approximately same when obtained from both the methods. Also, QALD’s are not significantly affected even if individuals spend out of pocket in case of private hospitals for childbirth and maternity cases. Thus maximum utility is derived in case of treatment for a pregnant woman. The different functional forms of utilities are formed based on assumption of patient’s behavior. The duration of stay in both the hospitals gives the value of quality adjusted life days instead of expressing the result in the form of QALY. Under different quintile class lower the economic quintile class higher the proportion of institutional childbirth that took place in public as compared to private hospitals. This study also gives us an overview about how well our facilities for childbirth and maternity services are prevalent in both the type of hospitals and how far is the patient able to access it.
Application/ Improvement: This unit of health outcome will help the health economists in the allocation of health care resources. New methods for estimation of functional forms of utilities can also be applied.
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