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Are Preferences for Equality a Matter of Perspective?

Author

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  • David L.B. Schwappach

    (University Witten/Herdecke, Department of Health Policy and Management, Faculty of Medicine, Witten, Germany, Davids@uni-wh.de)

Abstract

Background . Many subjects attach equal value to different health care programs in surveys eliciting preferences for resource allocation. It has been suggested that subjects may be prepared to attach different priority if they were asked to evaluate someone else’s decision instead of adopting the role of a social decision maker. This study investigated whether the perspective individuals are asked to adopt affects their priority setting decisions and the likelihood of assigning equal value to health care programs. Methods . 1253 members of an Internet panel were presented a set of clinical vignettes describing preventive health care initiatives and were asked to prioritize among these. They choose between “discrimination,†that is, allocating all resources on the better program, and “equality,†that is, dividing the resources equally between programs while reducing efficiency. Respondents were randomized to either of 4 survey versions that differed in terms of perspective (evaluator vs. decision maker) and expert status (expert vs. layperson) of the role to be adopted. Results . Subjects in the evaluator perspectives were more likely to choose equality over discrimination between patients as compared to those in the social decision-maker perspectives, regardless of expert status (odds ratios 2.09 and 2.03 , P

Suggested Citation

  • David L.B. Schwappach, 2005. "Are Preferences for Equality a Matter of Perspective?," Medical Decision Making, , vol. 25(4), pages 449-459, July.
    • Handle: RePEc:sae:medema:v:25:y:2005:i:4:p:449-459
    DOI: 10.1177/0272989X05276861
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    Cited by:

    1. Aki Tsuchiya & Verity Watson, 2017. "Re‐Thinking ‘The Different Perspectives That can be Used When Eliciting Preferences in Health’," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 103-107, December.
    2. Coast, Joanna, 2009. "Maximisation in extra-welfarism: A critique of the current position in health economics," Social Science & Medicine, Elsevier, vol. 69(5), pages 786-792, September.
    3. Schwappach, David L.B. & Strasmann, Thomas J., 2006. ""Quick and dirty numbers"?: The reliability of a stated-preference technique for the measurement of preferences for resource allocation," Journal of Health Economics, Elsevier, vol. 25(3), pages 432-448, May.
    4. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.

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