Since 1988, the Department of Transport has used a Willingness To Pay approach to value road accident fatalities by considering what people would be willing to pay to reduce the risk of being killed in a road accident (Dalvi, 1988, see IRRD 816786). The direct economic costs (net output and medical costs) are also included in the valuation of a fatality. Since then the Department of Transport has been committed to adopting a similar approach to the costs of non-fatal casualties. This project forms part of the programme of research being carried out by TRRL aimed at revaluing non-fatal casualty costs (described in TRRL leaflet LF 2047). This report is concerned with reviewing a range of methodologies and recommending methods for estimating monetary values for the avoidance of 'serious' non-fatal injuries to be used in the next, empirical, stage of the work. A separate project uses Willingness To Pay and similar techniques to elicit valuations from samples of the general public. The report presents a review of the literature on relative utility loss methodologies as applied in the UK, in other European countries and in the USA and Canada both in the fields of health economics and clinical assessment. The report discusses the features of the Relative Utility Loss Approach (RULA). Utility theory provides a rational model of how decisions are arrived at under conditions of uncertainty. Utility is a general concept for assessing the value a given individual may place on the consequences of different courses of action. These values can then reflect the relative quality or desirability of different health states.

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