Eliciting a monetary threshold for a year of sufficient capability to inform resource allocation decisions in public health and social care

Abstract

AimTo elicit a deliberative monetary value for a year of sufficient capability well-being (YSC) and a year of full capability (YFC), to inform decision-making in the contexts of social care and public health. Methods69 members of the public, recruited from purposively selected electoral wards across the West Midlands Region of England, attended one of six deliberative workshops in 2017. Participants were informed about the nature of public health and social care, and the funding of these services by local authorities. Participants were then asked to report: their willingness to pay additional tax (ring-fenced for social care/public health services); and the maximum amount they would be willing to allocate for social care/public health services from an existing local authority budget. In both cases they were asked to assume that the funding would result in improved well-being equivalent to a YSC. The second task was repeated for improved well-being equivalent to a YFC. Representatives from the six initial workshops reconvened at a consensus workshop to arrive at a final arbitrated value for a YSC and YFC. ResultsMean values elicited during the initial workshops increased after discussion (from £442 to £451 in the case of WTP additional tax). Almost half of participants changed their response post-discussion when reporting a societal (aggregated) WTP. The arbitrated value of a YSC was £33,500, with a range of £33,500 to £36,150 emerging as the value of a YFC. DiscussionThis is the first study to use a deliberative approach to elicit a monetary threshold for an additional YSC/YFC. Qualitative research supports the validity of responses to the taxation question. Deliberation appears to have influenced the societal (aggregated) values reported by participants. ConclusionFuture research should explore the robustness of a monetary threshold of £33,500 for a YSC.