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  • 1.
    Andersson, Henrik
    et al.
    Toulouse School of Economics (LERNA, UT1C, CNRS), Toulouse, France.
    Hole, Arne Risa
    University of Sheffield, Sheffield, United Kingdom.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Karlstad University, Karlstad, Sweden; Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Valuation of small and multiple health risks: A critical analysis of SP data applied to food and water safety2016In: Journal of Environmental Economics and Management, ISSN 0095-0696, E-ISSN 1096-0449, Vol. 75, p. 41-53Article in journal (Refereed)
    Abstract [en]

    This study elicits individual risk preferences in the context of an infectious disease using choice experiments. A main objective is to examine scope sensitivity using a novel approach. Our results suggest that the value of a mortality risk reduction (VSL) is highly sensitive to the survey design. Our results cast doubt on the standard scope sensitivity tests in choice experiments, but also on the validity and reliability of VSL estimates based on stated-preference studies in general. This is important due to the large empirical literature on non-market evaluation and the elicited values' central role in policy making.

  • 2.
    Andersson, Henrik
    et al.
    Department of Transport Economics, Swedish National Road and Transport Research Institute (VTI), Stockholm, Sweden.
    Svensson, Mikael
    Örebro University, Department of Business, Economics, Statistics and Informatics.
    Cognitive ability and scale bias in the contingent valuation method: An analysis of willingness to pay to reduce mortality risk2008In: Environmental and Resource Economics, ISSN 0924-6460, E-ISSN 1573-1502, Vol. 39, no 4, p. 481-495Article in journal (Refereed)
    Abstract [en]

    This study investigates whether or not the scale bias found in contingent valuation (CVM) studies on mortality risk reductions is a result of cognitive constraints among respondents. Scale bias refers to insensitivity and non-near-proportionality of the respondents’ willingness to pay (WTP) to the size of the risk reduction. Two hundred Swedish students participated in an experiment in which their cognitive ability was tested before they took part in a CVM-study asking them about their WTP to reduce bus-mortality risk. The results imply that WTP answers from respondents with a higher cognitive ability are less flawed by scale bias

  • 3.
    Andersson, Henrik
    et al.
    Toulouse School of Economics, Toulouse, France.
    Svensson, Mikael
    Karlstad University, Karlstad, Sweden.
    Scale sensitivity and question order in the contingent valuation method2014In: Journal of Environmental Planning and Management, ISSN 0964-0568, E-ISSN 1360-0559, Vol. 57, no 11, p. 1746-1761Article in journal (Refereed)
    Abstract [en]

    This study examines the effect on respondents’ willingness to pay to reduce mortality risk by the order of the questions in a stated preference study. Using answers from an experiment conducted on a Swedish sample where respondents’ cognitive ability was measured and where they participated in a contingent valuation survey, it was found that scale sensitivity is strongest when respondents are asked about a smaller risk reduction first (‘bottom-up’ approach). This contradicts some previous evidence in the literature. It was also found that the respondents’ cognitive ability is more important for showing scale sensitivity when respondents are asked about a larger risk reduction first (‘top-down’ approach), also reinforcing the result that a ‘bottom-up’ approach is more consistent with answers in line with theoretical predictions for a larger proportion of respondents.

  • 4.
    Andrén, Daniela
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Part-time sick leave as a treatment method for individuals with musculoskeletal disorders2009Report (Other academic)
  • 5.
    Andrén, Daniela
    et al.
    Örebro University, Örebro University School of Business.
    Svensson, Mikael
    Department of Economics and Statistics, Karlstad University, Karlstad, Sweden.
    Part-time sick leave as a treatment method for individuals with musculoskeletal disorders2012In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 22, no 3, p. 418-426Article in journal (Refereed)
    Abstract [en]

    Introduction: There is increasing evidence that staying active is an important part of a recovery process for individuals on sick leave due to musculoskeletal disorders (MSDs). It has been suggested that using part-time sickleave rather than full-time sick leave will enhance the possibility of full recovery to the workforce, and several countries actively favor this policy. The aim of this paper is to examine if it is beneficial for individuals on sick leave due to MSDs to be on part-time sick leave compared to full-time sick leave.

    Methods: A sample of 1,170 employees from the RFV-LS (register) database of the Social Insurance Agency of Sweden is used. The effect of being on part-time sick leave compared to full-time sick leave is estimated for the probability of returning to work with full recovery of lost work capacity. A two-stage recursive bivariate probit model is used to deal with the endogeneity problem.

    Results: The results indicate that employees assigned to part-time sick leave do recover to full work capacity with a higher probability than those assigned to full-time sick leave. The average treatment effect of parttime sick leave is 25 percentage points.

    Conclusions: Considering that part-time sick leave may also be less expensive than assigning individuals to full-time sick leave, this would imply efficiency improvements from assigning individuals, when possible, to part-time sick leave.

  • 6. Arnek, Magnus
    et al.
    Bergman, MatsEdquist, HaraldHultkrantz, LarsÖrebro University, Örebro University School of Business.Lundberg, SofiaSvensson, MikaelÖrebro University, Örebro University School of Business.
    Den offentliga sektorn: en antologi om att mäta produktivitet och prestationer2013Collection (editor) (Other (popular science, discussion, etc.))
  • 7.
    Beckman, Linda
    et al.
    Department of Public Health, Karlstad University, Karlstad, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Health Metrics Unit, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    The cost-effectiveness of the Olweus Bullying Prevention Program: Results from a modelling study2015In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 45, p. 127-137Article in journal (Refereed)
    Abstract [en]

    Exposure to bullying affects around 3-5 percent of adolescents in secondary school and is related to various mental health problems. Many different anti-bullying programmes are currently available, but economic evaluations are lacking. The aim of this study is to identify the cost effectiveness of the Olweus Bullying Prevention Program (OBPP). We constructed a decision-tree model for a Swedish secondary school, using a public payer perspective, and retrieved data on costs and effects from the published literature. Probabilistic sensitivity analysis to reflect the uncertainty in the model was conducted. The base-case analysis showed that using the OBPP to reduce the number of victims of bullying costs 131 250 Swedish kronor ((sic)14 470) per victim spared. Compared to a relevant threshold of the societal value of bullying reduction, this indicates that the programme is cost-effective. Using a relevant willingness-to-pay threshold shows that the OBPP is a cost-effective intervention. (C) 2015 The Foundation for Professionals in Services for Adolescents.

  • 8.
    Beckman, Linda
    et al.
    Department of Public Health, Örebro University, Örebro, Sweden; Department of Public Health, Karlstad University, Karlstad, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Frisen, Ann
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Preference-based health-related quality of life among victims of bullying2016In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, no 2, p. 303-309Article in journal (Refereed)
    Abstract [en]

    Purpose: No previous study has estimated the association between bullying and preference-based health-related quality of life (HRQoL) ("utility''), knowledge of which may be used for cost-effectiveness studies of interventions designed to prevent bullying. Therefore, the aim of the study was to estimate preference-based HRQoL among victims of bullying compared to non-victims.

    Methods: A cross-sectional survey data collection among Swedish adolescents aged 15-17 years in the first year of upper secondary school was conducted in the city of Gothenburg in Sweden (N = 758). Preference-based HRQoL was estimated with the SF-6D. Regression analyses were conducted to adjust for some individual-level background variable.

    Results: Mean preference-based health-related quality of life scores were 0.77 and 0.71 for non-victims and victims of bullying, respectively. The difference of 0.06 points was statistically significant (p < 0.05) and robust to inclusion of gender, age, and parental immigrant status.

    Conclusions: The preference-based HRQoL estimates in this study may be used as an upper bound in economic evaluations of bullying prevention interventions, facilitating a comparison between costs and quality-adjusted lifeyears.

  • 9.
    Bonander, Carl
    et al.
    Karlstad University, Karlstad, Sweden.
    Jakobsson, Niklas
    Karlstad University, Karlstad, Sweden; Norwegian Social Research (NOVA), Oslo, Norway.
    Podesta, Federico
    FBK-IRVAPP, Trento, Italy.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Universities as engines for regional growth?: Using the synthetic control method to analyze the effects of research universities2016In: Regional Science and Urban Economics, ISSN 0166-0462, E-ISSN 1879-2308, Vol. 60, p. 198-207Article in journal (Refereed)
    Abstract [en]

    Are research universities important for regional growth and development? We study the impact on the regional economy of granting research university status to three former university colleges in three different regions in Sweden. We analyze the development in the treated regions compared to a set of control regions that are created using the synthetic control method. We find small or no effects on the regional economy. Our findings cast doubt on the effectiveness of research universities in fostering regional growth and development We contribute to the existing research by using a more credible identification strategy in assessing the effects of universities on the regional economy compared to what has usually been used in previous studies.

  • 10.
    Dorjdagva, Javkhlanbayar
    et al.
    Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
    Batbaatar, Enkhjargal
    Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Health Metrics Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Dorjsuren, Bayarsaikhan
    Department of Health Systems Governance and Financing, WHO, Geneva, Switzerland.
    Kauhanen, Jussi
    Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
    Catastrophic health expenditure and impoverishment in Mongolia2016In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, article id 105Article in journal (Refereed)
    Abstract [en]

    Background: The social health insurance coverage is relatively high in Mongolia; however, escalation of out-ofpocket payments for health care, which reached 41 % of the total health expenditure in 2011, is a policy concern. The aim of this study is to analyse the incidence of catastrophic health expenditures and to measure the rate of impoverishment from health care payments under the social health insurance scheme in Mongolia.

    Methods: We used the data from the Household Socio-Economic Survey 2012, conducted by the National Statistical Office of Mongolia. Catastrophic health expenditures are defined an excess of out-of-pocket payments for health care at the various thresholds for household total expenditure (capacity to pay). For an estimate of the impoverishment effect, the national and The Wold Bank poverty lines are used.

    Results: About 5.5 % of total households suffered from catastrophic health expenditures, when the threshold is 10 % of the total household expenditure. At the threshold of 40 % of capacity to pay, 1.1 % of the total household incurred catastrophic health expenditures. About 20,000 people were forced into poverty due to paying for health care.

    Conclusions: Despite the high coverage of social health insurance, a significant proportion of the population incurred catastrophic health expenditures and was forced into poverty due to out-of-pocket payments for health care.

  • 11.
    Finseraas, Henning
    et al.
    NOVA, Centre for Welfare and Labour Research, Oslo and Akershus University College of Applied Sciences (HiOA), Oslo, Norway; Institute for Social Research, Oslo, Norway.
    Jakobsson, Niklas
    NOVA, Centre for Welfare and Labour Research, Oslo and Akershus University College of Applied Sciences (HiOA), Oslo, Norway; Karlstad Business School, Karlstad University, Karlstad, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Karlstad Business School, Karlstad University, Karlstad, Sweden.
    Do knowledge gains from public information campaigns persist over time?: Results from a survey experiment on the Norwegian pension reform2017In: Journal of Pension Economics and Finance, ISSN 1474-7472, E-ISSN 1475-3022, Vol. 16, no 1, p. 108-117Article in journal (Refereed)
    Abstract [en]

    Government authorities use resources on information campaigns in order to inform citizens about relevant policy changes. The motivation is usually that individuals sometimes are ill-informed about the public policies relevant for their choices. In a survey experiment where the treatment group was provided with public information material on the social security system, we assess the short- and medium-term knowledge effects. We show that the short run effects of the information on knowledge disappear completely within 4 months. The findings illustrate the limits of public information campaigns to improve knowledge about relevant policy reforms.

  • 12. Gustavsson, Anders
    et al.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Jacobi, Frank
    Allgulander, Christer
    Alonso, Jordi
    Beghi, Ettore
    Dodel, Richard
    Ekman, Mattias
    Faravelli, Carlo
    Fratiglioni, Laura
    Gannon, Brenda
    Jones, David Hilton
    Jennum, Poul
    Jordanova, Albena
    Jonsson, Linus
    Karampampa, Korinna
    Knapp, Martin
    Kobelt, Gisela
    Kurth, Tobias
    Lieb, Roselind
    Linde, Mattias
    Ljungcrantz, Christina
    Maercker, Andreas
    Melin, Beatrice
    Moscarelli, Massimo
    Musayev, Amir
    Norwood, Fiona
    Preisig, Martin
    Pugliatti, Maura
    Rehm, Juergen
    Salvador-Carulla, Luis
    Schlehofer, Brigitte
    Simon, Roland
    Steinhausen, Hans-Christoph
    Stovner, Lars Jacob
    Vallat, Jean-Michel
    Van den Bergh, Peter
    van Os, Jim
    Vos, Pieter
    Xu, Weili
    Wittchen, Hans-Ulrich
    Jonsson, Bengt
    Olesen, Jes
    Cost of disorders of the brain in Europe 20102011In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 21, no 10, p. 718-779Article in journal (Refereed)
    Abstract [en]

    Background: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of 386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people. Aims: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country. Methods: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27 + Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010. Results: The total cost of disorders of the brain was estimated at (sic)798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between (sic)285 for headache and (sic)30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was (sic)1550 on average but varied by country. The cost (in billion (sic)PPP 2010) of the disorders of the brain included in this study was as folows: addiction: (sic)65.7; anxiety disorders: (sic)74.4; brain tumor: (sic)5.2; child/adolescent disorders: (sic)21.3; dementia: (sic)105.2; eating disorders: (sic)0.8; epilepsy: (sic)13.8; headache: (sic)43.5; mental retardation: (sic)43.3; mood disorders: (sic)113.4; multiple sclerosis: (sic)14.6; neuromuscular disorders: (sic)7.7; Parkinson's disease: (sic)13.9; personality disorders: (sic)27.3; psychotic disorders: (sic)93.9; sleep disorders: (sic)35.4; somatoform disorder: (sic)21.2; stroke: (sic)64.1; traumatic brain injury: (sic)33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted (sic)477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US. Discussion: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges. Recommendations: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives. (C) 2011 Published by Elsevier B.V.

  • 13.
    Gustavsson, Anders
    et al.
    Optumlnsight, Stockholm, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Department of Economics and Statistics, Karlstad University, Karlstad, Sweden.
    Jacobi, Frank
    Institute of Clinical Psychology and Psychotherapy, Centre of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
    Allgulander, Christer
    Department of Clinical Neuroscience, Karolinska University Hospital, Huddinge, Sweden.
    Alonso, Jordi
    Health Services Research Unit, IMIM-Hospital del Mar, Barcelona, Spain.
    Beghi, Ettore
    Laboratorio Malattie Neurologiche, Istituto Mario Negri, Milano, Italy.
    Dodel, Richard
    Department of Neurology Marburg, Philips University, Marburg, Germany.
    Ekman, Mattias
    Optumlnsight, Stockholm, Sweden.
    Faravelli, Carlo
    Department of Psychology, Florence University, Florence, Italy.
    Fratiglioni, Laura
    Aging Research Centre, Karolinska Institute, Stockholm, Sweden.
    Gannon, Brenda
    Academic Unit of Health Economics, Leeds Institute of Health Sciences, Leeds, United Kingdom.
    Jones, David Hilton
    Department of Clinical Neurology, John Radcliffe Hospital, Oxford, United Kingdom.
    Jennum, Pout
    Centre for Sleep Medicine, Glosptup Hospital, Copenhagen, Denmark.
    Jordanova, Albena
    Department of Molecular Genetics, VIB/University of Antwerp, Antwerpen, Belgium; Neurogenetics Laboratory, Institute Born Bunge, University of Antwerp, Antwerpen, Belgium; Department of Chemistry and Biochemistry, Molecular Medicine Centre, Medical University, Sofia, Bulgaria.
    Jonsson, Linus
    Optumlnsight, Stockholm, Sweden.
    Karampampa, Korinna
    Optumlnsight, Stockholm, Sweden.
    Knapp, Martin
    Personal Social Services Research Unit, London School of Economics, London, United Kingdom; Centre for the Economics of Mental Health, Institute of Psychiatry, King's College, London, United Kingdom.
    Kobelt, Gisela
    Lund University, Lund, Sweden; European Health Economics, Mulhouse, France.
    Kurth, Tobias
    Department of Epidemiology, Harvard School of Public Health, Boston, United States.
    Lieb, Roselind
    Department of Psychology, University of Basel, Basel, Switzerland.
    Linde, Mattias
    Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Division of Neurology and Neurophysiology, St Olavs Hospital, Trondheim, Norway.
    Ljungcrantz, Christina
    Optumlnsight, Stockholm, Sweden..
    Maercker, Andreas
    Department of Psychology, University of Zürich, Zürich, Switzerland.
    Melin, Beatrice
    Department of Oncology, University of Umeå, Umeå, Sweden.
    Moscarelli, Massimo
    International Centre of Mental Health Policy and Economics, Milan, Italy; Harvard Medical School, Boston, United States.
    Musayev, Amir
    Optumlnsight, Stockholm, Sweden.
    Norwood, Fiona
    Department of Neurology, King's College Hospital, London, United Kingdom.
    Preisig, Martin
    Department of Psychiatry, University Hospital Centre, University of Lausanne, Lausanne, Switzerland.
    Pugliatti, Maura
    Department of Neurosciences, University of Sassari, Sassari, Italy.
    Rehm, Juergen
    Technische Universität Dresden, Dresden, Germany; Centre for Addiction and Mental Health, Toronto, Canada.
    Salvador-Carulla, Luis
    Asociación Científica PSICOST, Jerez de la Frontera, Spain; Psiquiatría, Departamento de Neurociencias, Universidad de Cádiz, Cádiz, Spain.
    Schlehofer, Brigitte
    German Cancer Research Centre, Heidelberg, Germany.
    Simon, Roland
    European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal.
    Steinhausen, Hans-Christoph
    Aalborg Psychiatric Hospital, Aalborg, Denmark; Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland; Department of Child and Adolescent Psychiatry, University of Zürich, Zürich, Switzerland.
    Stovner, Lars Jacob
    Norwegian National Headache Centre, Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; St. Olavs Hospital, Trondheim, Norway.
    Vallat, Jean-Michel
    Centre national de référence neuropathies périphériques rares, Department of Neurology, University Hospital, Limoges, France.
    Van den Bergh, Peter
    Centre De Référence Neuromusculaire, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
    van Os, Jim
    Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, Netherlands; Division of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.
    Vos, Pieter E.
    Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands.
    Xu, Weili
    Aging Research Centre, Karolinska Institute, Stockholm, Sweden.
    Wittchen, Hans-Ulrich
    Institute of Clinical Psychology and Psychotherapy, Centre of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.
    Jonsson, Bengt
    Stockholm School of Economics, Stockholm, Sweden.
    Olesen, Jes
    Danish Headache Centre at the Department of Neurology, Glostrup University Hospital, Glostrup, Denmark.
    Corrigendum to “Cost of disorders of the brain in Europe 2010” [Eur. Neuropsychopharmacol. 21 (2011) 718–779]2012In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 22, no 3, p. 237-238Article in journal (Refereed)
  • 14.
    Hultkrantz, Lars
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Örebro University School of Business.
    A comparison of cost benefit and cost utility analysis in practice: divergent policies by government agencies in Sweden2011Conference paper (Other academic)
    Abstract [en]

    This paper compares state-of-the-art implementation of Cost Benefit Analysis (CBA) and Cost Utility Analysis (CUA) as tools for making priorities in allocation of national public funds in the transport sector and health sector, respectively, in Sweden. These methods have several similarities although they diverge on how to treat effects on health and life length. However, it is shown here that there are considerable differences in how the methods are implemented in the decision process. The paper discusses differences in which cost and benefit components that are included, economic parameters, and the role of economic evaluation in the decision making. We believe that both transport and health sector planners have a lot to learn from each other.

  • 15.
    Hultkrantz, Lars
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Örebro University School of Business.
    Ekonomiska utvärderingar i svensk offentlig sektor - likheter och skillnader2015In: Ekonomisk Debatt, ISSN 0345-2646, Vol. 43, no 3, p. 40-50Article in journal (Other academic)
  • 16.
    Hultkrantz, Lars
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Örebro University School of Business.
    Hälsorelaterad livskvalitet i den svenska befolkningen - en väg framåt?2013In: Den offentliga sektorn: en antologi om att mäta produktivitet och prestationer / [ed] Magnus Arnek, Mats Bergman, Harald Edquist, Lars Hultkrantz, Sofia Lundberg, Mikael Svensson, Stockholm: Finansdepartementet, Regeringskansliet , 2013, 1, p. 93-114Chapter in book (Other academic)
  • 17.
    Hultkrantz, Lars
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Örebro University School of Business.
    The value of a statistical life in Sweden: a review of the empirical literature2012In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 108, no 2-3, p. 302-310Article in journal (Refereed)
    Abstract [en]

    Recent focus on cost-benefit/socio-economic assessment of government "life-saving" programmes within public health, pharmaceutics, transport, and civil contingencies has spurred a wave of empirical research on the value of a statistical life (VSL) in Sweden. This paper provides an overview of the received evidence from a range of studies in one country and over a relatively short time period. A literature search was conducted in Econlit, Pubmed, Google Scholar and in bibliographies of published papers. Twelve studies on VSL with a total of 48 VSL estimates, published with data from Sweden from 1996 onwards, were identified. Among all estimates VSL varies from 9 to 1121 million SEK (€0.9-121 million). Based on a set of additional quality inclusion criteria, as used also in a recent global review of VSL studies, the sample is restricted to 9 studies with a total of 29 VSL estimates with VSL varying from 9 to 98 million SEK (€0.9-10.6 million). The raw mean among these estimates is 34.6 million SEK (€3.7 million) and the median is 23 million SEK (€2.5 million). Currently, official authorities in Sweden recommend a VSL of 22 million Swedish kronor (€2.4 million). We also point out important concerns regarding validity of these estimates: primarily the problem that VSL is significantly related to the size of the mortality risk reduction showing significant scale insensitivity, in contrast to theoretical assumptions but in line with previous empirical findings.

  • 18.
    Hultkrantz, Lars
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Värdet av liv2008In: Ekonomisk debatt, ISSN 0345-2646, Vol. 36, no 2, p. 5-16Article in journal (Other academic)
    Abstract [sv]

    Vi ställs varje dag inför avvägningar som innebär att små risker för att råka illa ut till liv och hälsa ställs mot annan konsumtion, t ex när vi trycker olika hårt på gaspedalen eller avstår från att platta till frisyren med en cykelhjälm. Även många prioriteringsbeslut i den offentliga sektorn har en sådan karaktär. För att kunna genomföra samhällsekonomiska analyser av säkerhetshöjande åtgärder krävs att räddade liv förses med en prislapp. I den här artikeln presenterar vi en översikt av forskningen kring värdering av liv med speciellt svenskt fokus, och föreslår att liv bör räddas upp till en kostnad av 21 miljoner kr. 

  • 19.
    Jakobsson, Niklas
    et al.
    Norwegian Social Research, Oslo, Norway.
    Persson, Mattias
    Örebro University, Örebro University School of Business.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Karlstad University, Karlstad, Sweden.
    Class-size effects on adolescents' mental health and well-being in Swedish schools2013In: Education Economics, ISSN 0964-5292, E-ISSN 1469-5782, Vol. 21, no 3, p. 248-263Article in journal (Refereed)
    Abstract [en]

    This paper analyzes whether class size has an effect on the prevalence of mental health problems and well-being among adolescents in Swedish schools. We use cross-sectional data collected in year 2008 covering 2755 Swedish adolescents in ninth grade from 40 schools and 159 classes. We utilize different econometric approaches to address potential between- and within-school endogeneity including school-fixed effects and regression discontinuity approaches. Our results indicate no robust effects of class size on the prevalence of mental health problems and well-being, and we cannot reject the hypothesis that class size has no effect on mental health and well-being at all.

  • 20.
    Jakobsson, Niklas
    et al.
    Department of Economics, Karlstad University, Karlstad, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Copayments and physicians visits: A panel data study of Swedish regions 2003-20122016In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 120, no 9, p. 1095-1099Article in journal (Refereed)
    Abstract [en]

    Objective: This paper analyzes how primary care physician visits are affected by the level of copayment in Sweden.

    Data source: We use data between the years 2003-2012 from 21 Swedish health care regions that have the mandate to set their own level of copayment. The copayment per visit varies between 10 and 20 for these years and regions.

    Study design: Our strategy to identify the causal effect and deal with unobserved endogeneity of price changes on physician visits is based on a panel data model using fixed effects to control for region and time and regional-variation in time trends.

    Principal finding: We cannot reject that the copayment has no statistical or economic effect of significance, and we estimate the "zero effect" with very high precision.

    Conclusion: In a setting with sub-national regions with autonomy to set copayments the results points to that the copayment is not an important predictor for the number of health care visits. The result is in line with some previous studies on European data where the range of copayments used tends to be relatively low.

  • 21.
    Jakobsson, Niklas
    et al.
    Department of Economics, Karlstad University, Karlstad, Sweden; Norwegian Social Research (NOVA), Oslo, Norway.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    The effect of copayments on primary care utilization: results from a quasi-experiment2016In: Applied Economics, ISSN 0003-6846, E-ISSN 1466-4283, Vol. 48, no 39, p. 3752-3762Article in journal (Refereed)
    Abstract [en]

    This article analyses how health-care utilization is affected by copayments in a tax-financed health-care system. The article utilizes a natural experiment in which a health-care region in Sweden changed the price of healthcare in such a way that primary care general physician prices increased by 33%. We use daily visit data in the treatment region and a neighbouring control region where no price change took place and analyse the effect using differences-in-differences as well as differences-in-differences-in-differences models. The results from the preferred models indicate no effect on health-care utilization due to the price change, a result that also holds across different socio-economic subregions in the treatment region.

  • 22. Jaldell, Henrik
    et al.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Värdering av olycksrisker: nationalekonomi2008Report (Other academic)
  • 23.
    Krüger, Niclas A.
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University. Dept Hlth & Environm Sci, Karlstad Univ, Karlstad, Sweden.
    Good times are drinking times: empirical evidence on business cycles and alcohol sales in Sweden 1861-20002010In: Applied Economics Letters, ISSN 1350-4851, E-ISSN 1466-4291, Vol. 17, no 6, p. 543-546Article in journal (Refereed)
    Abstract [en]

    This article studies the relationship between the business cycle and alcohol sales in Sweden using a data set for the years 1861-2000. Using wavelet-based band-pass filtering, it is found that there is a pro-cyclical relationship, i.e. alcohol sales increases in short-term economic upturns. Using moving window techniques, we see that the pro-cyclical relationship holds over the entire time period. We also find that alcohol sales are a long-memory process with nonstationary behaviour, i.e. a shock in alcohol sales has persistent effects.

  • 24.
    Krüger, Niclas A.
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    The impact of real options on willingness to pay for mortality risk reductions2009In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 28, no 3, p. 563-569Article in journal (Refereed)
    Abstract [en]

    Public investments are dynamic in nature, and decision making must account for the uncertainty, irreversibility and potential for future learning. In this paper we adapt the theory for investment under uncertainty for a public referendum setting and perform the first empirical test to show that estimates of the value of a statistical life (VSL) from stated preference surveys are highly dependent on the inclusion of the option value. Our results indicate an option value of a major economic magnitude. This implies that previously reported VSL estimates, used in societal benefit–cost analysis of health investments, are exaggerated.

  • 25.
    Nilsson, F. O. L.
    et al.
    Dental and Pharmaceutical Benefits Agency, Stockholm, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business.
    Arnberg, K.
    Dental and Pharmaceutical Benefits Agency, Stockholm, Sweden.
    Reimbursement decisions for pharmaceuticals in Sweden: the impact of cost-effectiveness and disease severity2014In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 17, no 7, p. A327-A327Article in journal (Other academic)
    Abstract [en]

    Objectives: The purpose of this study is to evaluate the impact of cost-effectiveness and disease severity on the drug reimbursement decisions made by the reimbursement agency TLV in Sweden.

    Methods: Cost-effectiveness is measured through the continuous variable cost per QALY, while disease severity is measured by a dichotomous variable indicating high- or not high disease severity. We analyze all reimbursement decisions from 2005 through 2011 where there is data available on cost per QALY and disease severity. Logistic regressions are used to evaluate the impact of cost-effectiveness and disease severity on the drug reimbursement decisions.

    Results: There are 102 decisions with the required data available, 86 where reimbursement was granted and 16 where reimbursement was denied. The median cost per QALY for the drugs that were granted reimbursement was 39 000 euro (9sek/euro), ranging from a negative cost per QALY (better and cheaper) to 136 000 euro. The median cost per QALY for the drugs that were denied reimbursement was 111 000 euro, ranging from 78 000 euro to 1 111 000 euro. The results from the logistic regression analysis show that both the cost per QALY and the level of disease severity are statistically significantly related to the probability of a drug being granted reimbursement. When the cost per QALY exceeds 56 000 euro for non-severe diseases, and 92 000 euro for severe diseases, the probability that reimbursement is denied is higher than the probability that reimbursement is granted.

    Conclusions: In Sweden, it is sometimes stated as a rule of thumb that 55 000 euro per QALY is a threshold for cost-effective interventions. Our model shows that at this cost-effectiveness ratio, the probability of a new drug becoming reimbursed is 91 % or 98 %, depending on disease severity

  • 26.
    Olesen, J
    et al.
    Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
    Gustavsson, A
    i3 Innovus, Stockholm, Sweden and KI Alzheimer’s Disease Research Center, Karolinska institutet, Stockholm, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Department of Economics and Statistics, Karlstad University, Karlstad, Sweden.
    Wittchen, H-U
    Institute of Clinical Psychology and Psychotherapy, Centre of Clinical and Epidemiological and Longitudinal Studies, Technische Universitaet Dresden, Dresden, Germany.
    Jönsson, B
    Department of Economics, Stockholm School of Economics, Stockholm, Sweden.
    The economic cost of brain disorders in Europe2012In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 19, no 1, p. 155-162Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: In 2005, we presented for the first time overall estimates of annual costs for brain disorders (mental and neurologic disorders) in Europe. This new report presents updated, more accurate, and comprehensive 2010 estimates for 30 European countries.

    METHODS: One-year prevalence and annual cost per person of 19 major groups of disorders are based on 'best estimates' derived from systematic literature reviews by panels of experts in epidemiology and health economics. Our cost estimation model was populated with national statistics from Eurostat to adjust to 2010 values, converting all local currencies to Euros (€), imputing cost for countries where no data were available, and aggregating country estimates to purchasing power parity-adjusted estimates of the total cost of brain disorders in Europe in 2010.

    RESULTS: Total European 2010 cost of brain disorders was €798 billion, of which direct health care cost 37%, direct non-medical cost 23%, and indirect cost 40%. Average cost per inhabitant was €5.550. The European average cost per person with a disorder of the brain ranged between €285 for headache and €30 000 for neuromuscular disorders. Total annual cost per disorder (in billion € 2010) was as follows: addiction 65.7; anxiety disorders 74.4; brain tumor 5.2; child/adolescent disorders 21.3; dementia 105.2; eating disorders 0.8; epilepsy 13.8; headache 43.5; mental retardation 43.3; mood disorders 113.4; multiple sclerosis 14.6; neuromuscular disorders 7.7; Parkinson's disease 13.9; personality disorders 27.3; psychotic disorders 93.9; sleep disorders 35.4; somatoform disorder 21.2; stroke 64.1; and traumatic brain injury 33.0.

    CONCLUSION: Our cost model revealed that brain disorders overall are much more costly than previously estimated constituting a major health economic challenge for Europe. Our estimate should be regarded as conservative because many disorders or cost items could not be included because of lack of data.

  • 27.
    Persson, Mattias
    et al.
    Örebro University, Örebro University School of Business.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Karlstad University, Karlstad, Sweden.
    The willingness to pay to reduce school bullying2013In: Economics of Education Review, ISSN 0272-7757, E-ISSN 1873-7382, Vol. 35, p. 1-11Article in journal (Refereed)
    Abstract [en]

    The number of programs used to reduce bullying in schools is increasing, but often with a lack of understanding of the effectiveness and monetary benefits. This paper uses a discrete choice experiment conducted in Sweden in the spring of 2010 to elicit the willingness to pay (WTP) to reduce school bullying. Non-parametric and parametric approaches indicate a mean marginal WTP of 5.95-8.48 Swedish kronor ((sic)0.66-0.95) for each reduced victim of bullying. The aggregate societal WTP for each reduced statistical victim of bullying, referred to here as the value of a statistical bullying-victim (VSBV), is then 585,090-835,280 Swedish kronor ((sic)65,446-93,431). The VSBV may be interpreted as the aggregate WTP to prevent one statistical case of a bullying-victim. The result may be used to conduct economic evaluations of antibullying programs, which is demonstrated here by a simple cost-benefit analysis of one of the most common antibullying programs. The VSBV may also be relevant for providing policymakers with useful information on taxpayers' preferred allocations to antibullying programs in general.

  • 28.
    Persson, Mattias
    et al.
    Örebro University, Örebro University School of Business.
    Wennberg, Linn
    University of Gothenburg, Sweden.
    Beckman, Linda
    Karlstad University, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. University of Gothenburg, Sweden.
    The Cost-Effectiveness of the KiVa Antibullying Program: Results from a Decision-Analytic ModelManuscript (preprint) (Other academic)
  • 29.
    Ryen, Linda
    et al.
    Swedish Civil Contingencies Agency, Karlstad, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Health Metrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Modelling the cost-effectiveness of impact-absorbing flooring in Swedish residential care facilities2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 3, p. 407-411Article in journal (Refereed)
    Abstract [en]

    Objective: Fall-related injuries among the elderly, specifically hip fractures, cause significant morbidity and mortality as well as imposing a substantial financial cost on the health care system. Impact-absorbing flooring has been advocated as an effective method for preventing hip fractures resulting from falls. This study identifies the cost-effectiveness of impact-absorbing flooring compared to standard flooring in residential care facilities for the elderly in a Swedish setting.

    Method: An incremental cost-effectiveness analysis was performed comparing impact-absorbing flooring to standard flooring using a Markov decision model. A societal perspective was adopted and incremental costs were compared to incremental gains in quality-adjusted life years (QALYs). Data on costs, probability transitions and health-related quality of life measures were retrieved from the published literature and from Swedish register data. Probabilistic sensitivity analysis was performed through a Monte Carlo simulation.

    Results: The base-case analysis indicates that the impact-absorbing flooring reduces costs and increases QALYs. When allowing for uncertainty we find that 60% of the simulations indicate that impact-absorbing flooring is cost-saving compared to standard flooring and an additional 20% that it has a cost per QALY below a commonly used threshold value

    Conclusions: Using a modelling approach, we find that impact-absorbing flooring is a dominant strategy at the societal level considering that it can save resources and improve health in a vulnerable population.

  • 30.
    Ryen, Linda
    et al.
    Department of Economics, Karlstad University, Karlstad, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business. Department of Economics, Karlstad University, Karlstad, Sweden.
    The willingness to pay for a quality adjusted life year: a review of the empirical literature2015In: Health Economics, ISSN 1057-9230, E-ISSN 1099-1050, Vol. 24, no 10, p. 1289-1301Article in journal (Refereed)
    Abstract [en]

    There has been a rapid increase in the use of cost-effectiveness analysis, with quality adjusted life years (QALYs) as an outcome measure, in evaluating both medical technologies and public health interventions. Alongside, there is a growing literature on the monetary value of a QALY based on estimates of the willingness to pay (WTP). This paper conducts a review of the literature on the WTP for a QALY. In total, 24 studies containing 383 unique estimates of the WTP for a QALY are identified. Trimmed mean and median estimates amount to 74,159 and 24,226 Euros (2010 price level), respectively. In regression analyses, the results indicate that the WTP for a QALY is significantly higher if the QALY gain comes from life extension rather than quality of life improvements. The results also show that the WTP for a QALY is dependent on the size of the QALY gain valued.

  • 31.
    Sandberg, Pär
    et al.
    Örebro University, Örebro University School of Business.
    Svensson, Mikael
    Örebro University, Örebro University School of Business.
    The cost of autism spectrum disorders: a review of the literature2013In: Journal of Mental Health Policy and Economics, ISSN 1091-4358, E-ISSN 1099-176X, Vol. 16, p. S30-S30Article in journal (Other academic)
  • 32.
    Sund, Björn
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Demographic determinants of incident experience and risk perception: do high-risk groups accurately perceive themselves as high-risk?Manuscript (preprint) (Other academic)
    Abstract [en]

    This paper analyses demographic determinants of incident experience and perception of risks, as well as the relationship between the two, for eight different risk domains. Analyses are conducted by merging the results of a Swedish population-based survey, which includes approximately 15 000 individuals, with demographic and economic register data. Being male is associated with higher incident experience yet a lower risk perception for nearly all risk domains. Lower socioeconomic status is associated with high incident experience for violence and falling accidents, but lower incident experience for road traffic accidents. For risk perception, lower socioeconomic status is associated with higher risk perception for falling accidents. On aggregate, ranking the different domains, respondents’ risk perception is almost in perfect correspondence to the ranking of actual incident experience, with the exception that the risk violence is ranked higher than indicated by actual incident experience. On a demographic group level, males and highly educated respondents perceive their risks to be lower than what is expected considering their actual incident experience.

  • 33.
    Sund, Björn
    et al.
    Karlstad Business School, Karlstad University, Karlstad, Sweden; Swedish Civil Contingencies Agency (MSB), Karlstad, Sweden; Department of Economics, Örebro University, Örebro, Sweden.
    Svensson, Mikael
    Örebro University, Örebro University School of Business.
    Andersson, Henrik
    Toulouse School of Economics (LERNA, UT1C, CNRS), Toulouse, France.
    Demographic determinants of incident experience and risk perception: do high-risk groups accurately perceive themselves as high-risk?2017In: Journal of Risk Research, ISSN 1366-9877, E-ISSN 1466-4461, Vol. 20, no 1, p. 99-117Article in journal (Refereed)
    Abstract [en]

    This paper analyzes demographic determinants of incident experience and risk perception, as well as the relationship between the two, for eight different risk domains. Analyses were conducted by merging the results of a Swedish population-based survey, which includes approximately 15,000 individuals, with demographic and socio-economic register data. Being male was associated with higher incident experience yet a lower risk perception for nearly all risk domains. Lower socioeconomic status was associated with higher incident experience for falls, and being a victim of violence but lower incident experience for road traffic accidents. Lower socioeconomic status was also associated with higher risk perception for falls. On aggregate, ranking the different domains, respondents' risk perception was in almost perfect correspondence to the ranking of actual incident experience, with the exception that the risk of being a victim of violence is ranked higher than indicated by actual incident experience. On a demographic group level, men and highly educated respondents perceive their risks to be lower than what is expected considering their actual incident experience.

  • 34.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Alcohol use and social interactions among adolescents in Sweden: do peer effects exist within and/or between the majority population and immigrants?2010In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 70, no 11, p. 1858-1864Article in journal (Refereed)
    Abstract [en]

    Are adolescents who attend schools with a high level of alcohol use and binge drinking more likely to use alcohol and binge drink themselves? This paper analyzes peer effects in adolescent drinking based on a survey of 13,070 adolescents conducted in Sweden in 2005. The empirical analysis uses a multi-level logistic model to account for non-observable heterogeneity between the schools and the results show that attending a school with a high level of alcohol use and frequent binge drinking is a strong predictor of alcohol use and binge drinking for the individual. Hardly any significant interaction effects are detected, implying that peer influence is similar across different adolescent sub-groups. Looking at adolescents with different ethnic backgrounds, it is found that the drinking-pattern of the Swedish majority population has a significant effect on drinking by Swedish individuals and immigrants from Nordic and European countries, but no effect on drinking by immigrants from non-European countries.

  • 35.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Cost-benefit analysis2010In: 21st century economics: a reference handbook. Vol 1 / [ed] Rhona C. Free, London: Sage Publications , 2010, p. 275-286Chapter in book (Other academic)
  • 36.
    Svensson, Mikael
    Örebro University, Department of Business, Economics, Statistics and Informatics.
    Do not go breaking your heart: Do economic upturns really increase heart attack mortality?2007In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 65, no 4, p. 833-841Article in journal (Refereed)
    Abstract [en]

    Several recent papers in the literature have documented a pro-cyclical effect between business cycles and mortality. In this paper, I explore the relationship between business cycles and incidence, mortality and lethality in acute myocardial infarction (AMI) in Sweden. The sample consists of 21 Swedish regions during the period 1987–2003. Results from the panel data estimations indicate that the business cycle effect is insignificant on overall rates of incidence, mortality and lethality. However, a counter-cyclical and significant effect is found in most specifications for those in prime working age between 20 and 49. Hence, previous recent results from the literature cannot be taken as universal for other countries or settings. It is also shown that a higher share of women, highly educated and non-foreigners decrease incidence and mortality.

  • 37.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Economic upturns are good for your heart but watch out for accidents: a study on Swedish regional data 1976-20052010In: Applied Economics, ISSN 0003-6846, E-ISSN 1466-4283, Vol. 42, no 5, p. 615-625Article in journal (Refereed)
    Abstract [en]

    This article explores the relationship between the regional unemployment rate in total and cause-specific mortality in Sweden during 1976-2005. Overall mortality is unrelated to changes in the unemployment rate, while the biggest cause of death (heart disease) decreases when the unemployment rate decreases. At the same time, other accidents, including job-related accidents, increases when the unemployment rate decreases. Swedish evidence provide no support for the US research findings, that 'short-term decreases in the unemployment rate are bad for your health', in general.

  • 38.
    Svensson, Mikael
    Örebro University, Department of Business, Economics, Statistics and Informatics.
    Estimates of the value of a statistical life from two Swedish surveys using the “certainty approach” calibrationManuscript (Other academic)
  • 39.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Hypotetisk bias vid direkta värderingsmetoder: Hur stort problem och vad kan man göra?2010Report (Other academic)
  • 40.
    Svensson, Mikael
    Örebro University, Department of Business, Economics, Statistics and Informatics.
    Methodological Issues in Estimating the Value of a Statistical Life2006Licentiate thesis, monograph (Other academic)
  • 41.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    Precautionary behavior and willingness to pay for a mortality risk reduction: searching for the expected relationship2009In: Journal of Risk and Uncertainty, ISSN 0895-5646, E-ISSN 1573-0476, Vol. 39, no 1, p. 65-85Article in journal (Refereed)
    Abstract [en]

    This paper examines within-sample correlation between six different precautionary behaviors and stated willingness to pay for a mortality risk reduction. The paper also shows estimates of the value of a statistical life based on seat belt and bicycle helmet use as well as based on the stated willingness to pay for a risk reduction in traffic mortality. Contrary to the theoretical expectations, no correlation is found between precautionary behavior and stated willingness to pay. One major explanation is that females and the elderly take more precaution, but state a lower WTP for a risk reduction. The estimates of VSL from the different approaches are 11.0 million,11.0million,5.0 million and $2.8 million from stated WTP, bicycle helmet use and seat belt use, respectively.

  • 42.
    Svensson, Mikael
    Örebro University, Department of Business, Economics, Statistics and Informatics.
    Stated and implicit value of a statistical life from stated WTP, seat belt use and bicycle helmet useManuscript (Other academic)
  • 43.
    Svensson, Mikael
    Örebro University, Swedish Business School at Örebro University.
    The value of a statistical life in Sweden: Estimates from two studies using the “Certainty Approach” calibration2009In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 41, no 3, p. 430-437Article in journal (Refereed)
    Abstract [en]

    Stated preference methods using surveys to elicit willingness to pay have been shown to suffer from hypothetical bias and scope/scale bias. Hypothetical bias usually means that willingness to pay is exaggerated in the hypothetical scenario and scope/scale bias means that there is an insensitivity in willingness to pay with regard to the amount of goods or the size of a good being valued. Experimental results in social psychology and economics have shown that only trusting the most certain respondents can potentially solve the problem with hypothetical bias and scope/scale bias. This paper presents the results of two different surveys in Sweden estimating the willingness to pay to reduce traffic mortality risks by only including the most certain respondents. Using the full sample, estimates of the value of a statistical life (VOSL) are $4.2 and $7.3 million. Estimates of VOSL on the subset of the samples only including the most certain respondents are lower and consistent between the two surveys with values of $2.9 and $3.1 million.

  • 44.
    Svensson, Mikael
    Örebro University, Department of Business, Economics, Statistics and Informatics.
    What is a life worth?: methodological issues in estimating the value of a statistical life2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis addresses methodological issues in estimating the value of a statistical life (VSL). Two main approaches have been used to estimate the VSL, the indirect and direct methods; the indirect method is based on revealed preferences, such as the wage premium demanded for a risky job. The direct method is based on surveys where respondents are asked about their willingness to pay for risk reductions.

    There are several methodological problems with both approaches. This thesis mainly concentrates on methodological problems with the direct approach; more specifically with the contingent valuation approach. Some problems are universal for all survey based research in economics, but there are also specific problems in using surveys to ask respondents about the willingness to pay for a small risk reduction.

    The first paper concerns the findings that individuals often show inadequate sensitivity to the scale of the provided good, i.e. the willingness to pay is almost the same for a risk reduction of 0.0001 as for a risk reduction of 0.00005. The results in the first paper show that there is a systematic bias with respect to scale insensitivity such that individuals with lower score on a basic cognitive ability test are more likely to not show scale sensitivity. Hence, scale bias can be considered as (at least partly) a problem based on respondents lack of understanding of the small changes in probabilities. The second paper concerns the problem of hypothetical bias, i.e. that respondents usually overstate their willingness to pay in a survey scenario. The paper proposes that more reliable VSL estimates may be calculated if only the most certain respondents are included in the final calculations. It has been shown in social psychology that certain (uncertain) respondents have a strong (weak) attitude-behavior relationship. In several recent lab and field experiments in economics; it has been shown that if the uncertain respondents that say they will buy the good are excluded: hypothetical surveys answers match individual behaviour in a “real market situation”. The results in the paper indicates that value of life estimates are approximately reduced by half if only trusting the answers from the certain respondents, and only trusting the certain respondents creates almost identical VSL estimates from two completely different surveys at around 20 million Swedish kronor (SEK).

    The third paper focuses on the consistent findings that the value of a statistical life is higher (lower) if the hypothetical good is described as a private (public) abstract good. We hypothesize that this is not, as previously discussed in the literature, dependent on different types of altruistic behaviour, but is dependent on pure preferences regarding the provider of the good. Results indicate that the private VSL is much higher among respondents that dislike public provision of goods in general, hence, even if the risk reductions are of equal magnitude, the goods are not considered equal dependent on the provider of the good.

    The fourth paper estimates the value of a statistical life based on stated willingness to pay and on stated behaviour regarding seat belt and bicycle helmet use. VSL estimates are in the range of 38 to 75 million SEK (highest for stated WTP). Further, as a validity test, it is found that individuals that state a high willingness to pay are also, as theoretically expected, more likely to wear seat belts. The fifth paper in the thesis differs from the first four, in that it rather concerns how the value of life estimates can be put to use in other contexts than only cost-benefit analysis. It estimates the relationship between changes in the unemployment rate and heart attack incidence, lethality and mortality. Results, based on regional panel data analysis in Sweden, indicate that among individuals aged 20-49 an increase in the unemployment rate increases heart attack incidence and mortality. Using value of life estimates, it is estimated that a one percentage point increase in the unemployment rate has a monetized “health cost” of 350 million SEK. The findings may be used to consider a broader societal cost of unemployment.

    List of papers
    1. Cognitive ability and scale bias in the contingent valuation method: An analysis of willingness to pay to reduce mortality risk
    Open this publication in new window or tab >>Cognitive ability and scale bias in the contingent valuation method: An analysis of willingness to pay to reduce mortality risk
    2008 (English)In: Environmental and Resource Economics, ISSN 0924-6460, E-ISSN 1573-1502, Vol. 39, no 4, p. 481-495Article in journal (Refereed) Published
    Abstract [en]

    This study investigates whether or not the scale bias found in contingent valuation (CVM) studies on mortality risk reductions is a result of cognitive constraints among respondents. Scale bias refers to insensitivity and non-near-proportionality of the respondents’ willingness to pay (WTP) to the size of the risk reduction. Two hundred Swedish students participated in an experiment in which their cognitive ability was tested before they took part in a CVM-study asking them about their WTP to reduce bus-mortality risk. The results imply that WTP answers from respondents with a higher cognitive ability are less flawed by scale bias

    National Category
    Social Sciences Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-2851 (URN)10.1007/s10640-007-9137-0 (DOI)
    Available from: 2007-10-12 Created: 2007-10-12 Last updated: 2017-12-14Bibliographically approved
    2. Estimates of the value of a statistical life from two Swedish surveys using the “certainty approach” calibration
    Open this publication in new window or tab >>Estimates of the value of a statistical life from two Swedish surveys using the “certainty approach” calibration
    (English)Manuscript (Other academic)
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-2852 (URN)
    Available from: 2007-10-12 Created: 2007-10-12 Last updated: 2017-10-18Bibliographically approved
    3. Willingness to pay for private and public safety: why the difference?
    Open this publication in new window or tab >>Willingness to pay for private and public safety: why the difference?
    (English)Manuscript (Other academic)
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-2853 (URN)
    Available from: 2007-10-12 Created: 2007-10-12 Last updated: 2017-10-18Bibliographically approved
    4. Stated and implicit value of a statistical life from stated WTP, seat belt use and bicycle helmet use
    Open this publication in new window or tab >>Stated and implicit value of a statistical life from stated WTP, seat belt use and bicycle helmet use
    (English)Manuscript (Other academic)
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-2854 (URN)
    Available from: 2007-10-12 Created: 2007-10-12 Last updated: 2017-10-18Bibliographically approved
    5. Do not go breaking your heart: Do economic upturns really increase heart attack mortality?
    Open this publication in new window or tab >>Do not go breaking your heart: Do economic upturns really increase heart attack mortality?
    2007 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 65, no 4, p. 833-841Article in journal (Refereed) Published
    Abstract [en]

    Several recent papers in the literature have documented a pro-cyclical effect between business cycles and mortality. In this paper, I explore the relationship between business cycles and incidence, mortality and lethality in acute myocardial infarction (AMI) in Sweden. The sample consists of 21 Swedish regions during the period 1987–2003. Results from the panel data estimations indicate that the business cycle effect is insignificant on overall rates of incidence, mortality and lethality. However, a counter-cyclical and significant effect is found in most specifications for those in prime working age between 20 and 49. Hence, previous recent results from the literature cannot be taken as universal for other countries or settings. It is also shown that a higher share of women, highly educated and non-foreigners decrease incidence and mortality.

    Place, publisher, year, edition, pages
    Amsterdam: Elsevier, 2007
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-7798 (URN)10.1016/j.socscimed.2007.04.015 (DOI)
    Available from: 2009-09-02 Created: 2009-09-02 Last updated: 2017-12-13Bibliographically approved
  • 45.
    Svensson, Mikael
    et al.
    Örebro University, Swedish Business School at Örebro University. Ctr Res Child & Adolescent Mental Hlth, Karlstad Univ, Karlstad, Sweden.
    Hagquist, Curt
    Ctr Res Child & Adolescent Mental Hlth, Karlstad Univ, Karlstad, Sweden.
    Adolescent alcohol and illicit drug use among first- and second-generation immigrants in Sweden2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 2, p. 184-191Article in journal (Refereed)
    Abstract [en]

    Aim: This article compares adolescent alcohol and illicit drug use among first- and second-generation immigrants from Nordic, non-Nordic European and non-European countries with that of the native Swedish majority population. Methods: Using data from a 2005 survey, multilevel logistic regression analysis was performed on a sample of 13,070 adolescents. The survey was conducted in three Swedish regions containing 24 municipalities. Results: Second-generation immigrants from Nordic countries were more likely to use alcohol and to binge drink, while first generation immigrants from non-European countries were less likely to; this difference is mainly explained by the relatively low use by girls from non-European countries. All immigrant groups were more likely to use illicit drugs than were the majority population. The highest drug use was found among first-generation Nordic immigrants and non-European immigrants. Consumption patterns among second-generation immigrants were more similar to those of the Swedish majority population, implying more alcohol use and less illicit drug use. Conclusions: Preventive policy for alcohol use should target Nordic immigrants in Sweden (second generation), while preventive policy for drug use, which is a more general immigrant phenomena, should mostly target both Nordic and non-European immigrants.

  • 46.
    Svensson, Mikael
    et al.
    Örebro University, Swedish Business School at Örebro University. Ctr Res Child & Adolescent Mental Hlth, Karlstad Univ, Karlstad, Sweden.
    Hagquist, Curt
    Karlstad University, Karlstad, Sweden.
    Adolescents alcohol-use and economic conditions: a multilevel analysis of data from a period with big economic changes2010In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 11, no 6, p. 533-541Article in journal (Refereed)
    Abstract [en]

    This paper examines how the unemployment rate is related to adolescent alcohol use and experience of binge drinking during a time period characterized by big societal changes. The paper uses repeated cross-sectional adolescent survey data from a Swedish region, collected in 1988, 1991, 1995, 1998, 2002 and 2005, and merges this with data on local unemployment rates for the same time periods. Individual level frequency of alcohol use as well as experience of binge drinking is connected to local level unemployment rate to estimate the relationship using multilevel modeling. The model includes municipality effects controlling for time-invariant differences between municipalities as well as year fixed effects controlling for municipality-invariant changes over time in alcohol use. The results show that the unemployment rate is negatively associated with adolescents' alcohol use and the experience of binge drinking. When the unemployment rate increases, more adolescents do not drink at all. Regular drinking (twice per month or more) is, on the other hand, unrelated to the unemployment rate. Examining gender-differences in the relationship, it is shown that the results are driven by behavior in girls, whereas drinking among boys does not show any significant relationship with changes in the unemployment rate.

  • 47.
    Svensson, Mikael
    et al.
    Örebro University, Örebro University School of Business. Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hultkrantz, Lars
    Örebro University, Örebro University School of Business.
    A Comparison of Cost-Benefit and Cost-Effectiveness Analysis in Practice: Divergent Policy Practices in Sweden2017In: Nordic Journal of Health Economics, ISSN 1892-9729, E-ISSN 1892-9710, Vol. 5, no 2, p. 41-53Article in journal (Refereed)
    Abstract [en]

    This paper compares the implementation of the two economic evaluation methods Cost-Effectiveness/Utility (CEA/CUA) and Cost-Benefit Analysis (CBA) as tools for allocation of national public funds in the health and transport sector in Sweden, respectively. We compare the recommended values for important economic parameters such as the social discount rate, the marginal cost of public funds, and the explicit and implicit valuation of health, and document a number of substantial and unexplained differences in implementation. Such differences are problematic considering that the increasing use of economic evaluations to guide policy decisions also has implied an overlap of application areas. We conclude with a discussion on the need of a harmonized procedure for economic evaluations in the public sector in order to reduce the risk of inefficient allocations purely due to different applications of the methods.

  • 48.
    Svensson, Mikael
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Krüger, Niclas A.
    Centre of Transport Studies, Royal Institute of Technology (KTH), Stockholm, Sweden; Swedish National Road and Transport Research Institute, Stockholm, Sweden.
    Mortality and economic fluctuations: evidence from wavelet analysis for Sweden 1800-20002012In: Journal of Population Economics, ISSN 0933-1433, E-ISSN 1432-1475, Vol. 25, no 4, p. 1215-1235Article in journal (Refereed)
    Abstract [en]

    Using wavelet methods, this paper analyzes the relationship between the age-adjusted, infant, and cause-specific mortality rates and the business cycle in Sweden over the period 1800–2000 (1911–1996 for cause-specific mortality). For the period 1800–2000, an increase in GDP by 1% decreased mortality by 0.7%. This overall relationship is due to a strong counter-cyclical relationship in the nineteenth century, which disappeared in the twentieth century. In contrast, in the twentieth century higher mortality in economic upturns is found for mortality caused by circulatory diseases (including stroke) and accidents.

  • 49.
    Svensson, Mikael
    et al.
    Örebro University, Örebro University School of Business. Sahlgrenska akademin, Göteborgs Universitet, Göteborg, Sweden.
    Nilsson, Fredrik
    Socialstyrelsen, Stockholm, Sweden.
    TLV:s betalningsvilja för nya läkemedel har analyserats: Kostnadseffektivitet och sjukdomens svårighetsgrad avgörande för subvention - Cancerläkemedel får kosta mer2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, no 28-30Article in journal (Refereed)
    Abstract [en]

    The Swedish Dental and Pharmaceutical Benefits Agency (TLV) is the government body responsible for deciding whether outpatient drugs are to be included in the pharmaceutical benefits scheme. This paper analyzed all decisions made by TLV between 2005 and 2011 in order to investigate how the cost-effectiveness of a drug and the severity of the disease the drug targets affected the likelihood of subsidy of a drug. We find that TLV places significant weight on both the costeffectiveness, measured as the cost per Quality-Adjusted Life Year (QALY), and disease severity. We also find that the higher cost per QALY approved for severe diseases is mainly represented by cancer drugs. Drugs targeting severe diseases other than cancer have a similar cost per QALY as for non-severe diseases.

  • 50.
    Svensson, Mikael
    et al.
    Örebro University, Örebro University School of Business.
    Nilsson, Fredrik O. L.
    The Dental and Pharmaceutical Benefits Agency (TLV), Stockholm, Sweden.
    Arnberg, Karl
    The Dental and Pharmaceutical Benefits Agency (TLV), Stockholm, Sweden.
    Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness2015In: PharmacoEconomics (Auckland), ISSN 1170-7690, E-ISSN 1179-2027, Vol. 33, no 11, p. 1229-1236Article in journal (Refereed)
    Abstract [en]

    The Swedish Dental and Pharmaceutical Benefits Agency (TLV) is the government body responsible for deciding whether outpatient drugs are to be included in the pharmaceutical benefits scheme. This paper analyzes the impact of cost effectiveness and severity of disease on reimbursement decisions for new pharmaceuticals.

    Data has been extracted from all decisions made by the TLV between 2005 and 2011. Cost effectiveness is measured as the cost per quality-adjusted life-year (QALY) gained, whereas disease severity is a binary variable (severe-not severe). In total, the dataset consists of 102 decisions, with 86 approved and 16 declined reimbursements.

    The lowest cost per QALY of declined reimbursements is Swedish kronor (SEK) 700,000 (a,not sign79,100), while the highest cost per QALY of approved reimbursements is SEK1,220,000 (a,not sign135,600). At a cost per QALY of SEK702,000 Swedish kronor (non-severe diseases) and SEK988,000 (severe diseases), the likelihood of approval is estimated to be 50/50 (a,not sign79,400 and a,not sign111,700).

    The TLV places substantial weight on both the cost effectiveness and the severity of disease in reimbursement decisions, and the implied willingness to pay for a QALY is higher than the often cited 'rule of thumb' in Swedish policy debates.

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