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Valorar la salud en todos los grupos: una encuesta transversal sobre la voluntad de pago de la población en Bután
Ying Yao1, Md Mizanur Rahman2, Pempa3
1Faculty of Economics, Keio University, Tokyo, Japan.
BMJ global health
|August 21, 2025
Resumen
Los hogares bhutaneses muestran voluntad de pagar (WTP) por las ganancias de salud, con estimaciones que varían según los ingresos y la educación. Estos hallazgos sirven de base a los umbrales nacionales de rentabilidad para la asignación de recursos sanitarios.
Área de la Ciencia:
- Economía de la salud
- Política de salud pública
- Disponibilidad para pagar por la investigación
Sus antecedentes:
- Los umbrales de rentabilidad específicos del contexto (UEC) son vitales para la asignación de recursos sanitarios en los países de ingresos bajos y medios.
- La disposición de la sociedad a pagar (WTP) es un factor determinante de estos umbrales.
- El sistema de salud de Bután requiere comprender el WTP local para una asignación efectiva de recursos.
Objetivo del estudio:
- Investigar la voluntad social de pagar (WTP) por las ganancias de salud, específicamente por año de vida ajustado por calidad (QALY), en Bután.
- Informar sobre el desarrollo de umbrales de rentabilidad específicos del contexto (CET) para Bután.
- Analizar los factores que influyen en el WTP para la salud de la población de Bután.
Principales métodos:
- Se realizó una encuesta nacional en Bután (n = 1869 hogares) junto con la Encuesta Nacional de Salud de 2023.
- Se empleó el método de valoración contingente, en el que los encuestados valoraban mejoras hipotéticas en la salud.
- Se utilizaron análisis de regresión lineal generalizada y multilevel para estimar la WTP y examinar las variaciones.
Principales resultados:
- Las estimaciones de WTP fueron de 104.381 ngultrum butanés (BTN) para 1 QALY y 235.237 BTN para 5 QALY.
- WTP varió significativamente en función de los ingresos individuales y los niveles de educación dentro de los distritos.
- Se observó una variación mínima en la WTP entre diferentes distritos.
Conclusiones:
- Las variaciones mínimas de WTP entre distritos apoyan un umbral de rentabilidad a nivel nacional (CET) para Bután.
- Los CET basados en WTP pueden estar sesgados hacia arriba por grupos de ingresos más altos y más educados.
- Este sesgo potencial podría llevar a la adopción de tecnologías costosas, agotando los recursos de atención médica pública de Bután.
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