No abstract

Waiting time generally acts as a rationing mechanism in the public health care system. In theory, patients who have a higher valuation of time are more likely to seek alternative care (i.e. doctor shopping) if there is a parallel private sector than those who have weaker time preference. However, the existing settings of many health care systems do not allow patients to reveal their preference of such. The data presented in this study suggest a positive association between patients' expressed value of time and doctor shopping behaviour in Hong Kong. Patients who were assigned longer waiting times relative to their expected horizon were more likely to seek private alternative care.

A key theoretical prediction concerning willingness to pay is that it is positively correlated with benefit size and is assessed by testing the 'sensitivity to scale (scope)'. 'External' (between-sample) sensitivity tests are usually regarded as less powerful than 'internal' (within-subject) tests. However, the latter may suffer from 'anchoring' effects. This paper studies the statistical power of these tests by questioning the distributional assumption of empirical data. We present an integrated model to capture both internal and external variations, while controlling for sample heterogeneity, applied to data from a survey estimating the value of reducing symptom-days. Results indicate that once data is properly transformed, WTP becomes 'scale sensitive' and consistent with diminishing marginal utility theory.