Impact of caregiver and parenting status on time trade-off and standard gamble utility scores for health state descriptions

Health and Quality of Life Outcomes

Jessica B Jordan²  Lee Bowman⁵  Joseph A Johnston³  David H Feeny⁴  Kristina S Boye⁶  Louis S Matza¹ 

[1] Senior Research Scientist, Outcomes Research, Evidera, Bethesda, MD, USA;Senior Research Associate, Outcomes Research, Evidera, Bethesda, MD, USA;Medical Fellow, Global Health Outcomes, Eli Lilly and Company, Indianapolis, IN, USA;Department of Economics (Professor Emeritus), University of Alberta, Edmonton, AB, Canada;Research Fellow, Global Health Outcomes, Oncology, Eli Lilly and Company, Indianapolis, IN, USA;Sr. Research Advisor, Global Health Outcomes, Diabetes, Eli Lilly and Company, Indianapolis, IN, USA

关键词: Cost-utility;    Parenting;    Caregiver;    Standard gamble;    Time trade-off;    Utility;   

Others  :  814990
DOI  :  10.1186/1477-7525-12-48

 received in 2013-08-28, accepted in 2014-03-12,  发布年份 2014

【 摘 要 】

Background

The purpose of this study was to examine the effect of caregiver status on time trade-off (TTO) and standard gamble (SG) health state utility scores. Respondents were categorized as caregivers if they reported that either children or adults depended on them for care.

Methods

This study was a secondary analysis of data from three studies in which general population samples rated health state descriptions. Study 1: UK; four osteoarthritis health states. Study 2: UK; three adult ADHD health states. Study 3: US; 16 schizophrenia health states. All three studies included time trade-off assessment. Study 1 also included standard gamble. Descriptive statistics were calculated to examine willingness to trade in TTO or gamble in SG. Utilities for caregivers and non-caregivers were compared using t-tests and ANCOVA models.

Results

There were 364 respondents including 106 caregivers (n = 30, 47, and 29 in Studies 1, 2, and 3) and 258 non-caregivers. Most caregivers were parents of dependent children (78.3%). Compared to non-caregivers, caregivers had more responses at the ceiling (i.e., utility = 0.95), indicating less willingness to trade time or gamble. All utilities were higher for caregivers than non-caregivers (mean utility difference between groups: 0.07 to 0.16 in Study 1 TTO; 0.03 to 0.17 in Study 1 SG; 0.06 to 0.10 in Study 2 TTO; 0.11 to 0.22 in Study 3 TTO). These differences were statistically significant for at least two health states in each study (p < 0.05). Results of sensitivity analyses with two caregiver subgroups (parents of dependent children and parents of any child regardless of whether the child was still dependent) followed the same pattern as results of the primary analysis. The parent subgroups were generally less willing to trade time or gamble (i.e., resulting in higher utility scores) than comparison groups of non-parents.

Conclusions

Results indicate that caregiver status, including being a parent, influences responses in time trade-off health state valuation. Caregivers (i.e., predominantly parents) were less willing than non-caregivers to trade time, resulting in higher utility scores. This pattern was consistent across multiple health states in three studies. Standard gamble results followed similar patterns, but with less consistent differences between groups. It may be useful to consider parenting/caregiving status when collecting, interpreting, or using utility data because this demographic variable could influence results.

【 授权许可】

   
2014 Matza et al.; licensee BioMed Central Ltd.

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