Are preferences over health states informed?

Health and Quality of Life Outcomes

Research

S. Paisley¹  J. Brazier¹  M. Karimi² 

[1] Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK;Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK;Health Economics and Evidence Synthesis Research Unit, Luxembourg Institute of Health, Strassen, Luxembourg;

关键词: Informed preferences;    EQ-5D;    QALY;    Health state valuation;   

DOI  :  10.1186/s12955-017-0678-9

 received in 2016-07-22, accepted in 2017-05-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe use of preference-elicitation tasks for valuing health states is well established, but little is known about whether these preferences are informed. Preferences may not be informed because individuals with little experience of ill health are asked to value health states. The use of uninformed preferences in cost-effectiveness can result in sub-optimal resource allocation. The aim of this study was to pilot a novel method to assess whether members of the public are informed about health states they value in preference-elicitation tasks.MethodsThe general public was said to be informed if the expectations of the public about the effect of ill health on people’s lives were in agreement with the experience of patients. Sixty-two members of the public provided their expectations of the consequences of ill health on five life domains (activities, enjoyment, independence, relationships, and avoiding being a burden). A secondary dataset was used to measure patient experience on those five consequences.ResultsThere were differences between the expectations of the public and the experience of patients. For example, for all five life consequences the public underestimated the effects of problems in usual activities compared to problems in mobility. They also underestimated the effect of ‘anxiety or depression’ compared to physical problems on enjoyment of life and on the quality of personal relationships.ConclusionsThis proof-of-concept study showed that it is possible to test whether preferences are informed. This study should be replicated using a larger sample. The findings suggest that preferences over health states in this sample are not fully informed because the participants do not have accurate expectations about the consequences of ill health. These uninformed preferences may not be adequate for allocation of public resources, and research is needed into methods to make them better informed.

【 授权许可】

CC BY   
© The Author(s). 2017