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Losing Sight of the Wood for the Trees

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  • Paul Dolan
  • Henry Lee

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  • Tessa Peasgood
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    Abstract

    Background and Objective: The ability to value health in a way that allows the comparison of different conditions across a range of population groups is central to determining priorities in healthcare. This paper considers some of the concerns with the ‘received wisdom’ in valuing health — to describe it using a generic descriptive system and to value it using the hypothetical preferences of the general public. Methods: The literature on the dimensions of health that matter most to people was reviewed and this paper discusses the use of global measures of subjective well-being (SWB) as a possible alternative. New analysis of the British Household Panel Survey was conducted to explore the relationship between life satisfaction and the preference-based quality-of-life measure the SF-6D. The impact on life satisfaction of each level for each dimension of the SF-6D is estimated through a linear model predicting life satisfaction with the SF-6D levels as determinants. Results: Valuing changes in the health of the general population via changes in life satisfaction would lead to different weights being attached to the different dimensions of health, as compared to a well used utility score in which weights are taken from general population preferences. If preferences elicited via standard gamble exercises are based only on a prediction of what it would be like to live in a particular health state, then these results suggest that reductions in physical functioning matter less than people imagine and reductions in mental health impact upon our lives more than preferences would suggest. Conclusions: Using data from the British Household Panel Survey, it is shown that a focus on SWB would place greater emphasis on mental health conditions. The implications for health policy are considered. Copyright Springer International Publishing AG 2012

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    Bibliographic Info

    Article provided by Springer in its journal PharmacoEconomics.

    Volume (Year): 30 (2012)
    Issue (Month): 11 (November)
    Pages: 1035-1049

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    Handle: RePEc:spr:pharme:v:30:y:2012:i:11:p:1035-1049

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    Web page: http://www.springer.com/economics/journal/40273

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    1. Brazier, John & Roberts, Jennifer & Deverill, Mark, 2002. "The estimation of a preference-based measure of health from the SF-36," Journal of Health Economics, Elsevier, vol. 21(2), pages 271-292, March.
    2. Oswald, Andrew J. & Powdthavee, Nattavudh, 2008. "Does happiness adapt? A longitudinal study of disability with implications for economists and judges," Journal of Public Economics, Elsevier, vol. 92(5-6), pages 1061-1077, June.
    3. Blanchflower, David G. & Oswald, Andrew J., 2007. "Hypertension and Happiness across Nations," IZA Discussion Papers 2633, Institute for the Study of Labor (IZA).
    4. Ada Ferrer-i-Carbonell & Paul Frijters, 2004. "How Important is Methodology for the estimates of the determinants of Happiness?," Economic Journal, Royal Economic Society, Royal Economic Society, vol. 114(497), pages 641-659, 07.
    5. Michael A. Shields & Stephen Wheatley Price, 2005. "Exploring the economic and social determinants of psychological well-being and perceived social support in England," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 168(3), pages 513-537.
    6. Paul Dolan & Daniel Kahneman, 2008. "Interpretations Of Utility And Their Implications For The Valuation Of Health," Economic Journal, Royal Economic Society, Royal Economic Society, vol. 118(525), pages 215-234, 01.
    7. Dolan, Paul & Peasgood, Tessa & White, Mathew, 2008. "Do we really know what makes us happy A review of the economic literature on the factors associated with subjective well-being," Journal of Economic Psychology, Elsevier, Elsevier, vol. 29(1), pages 94-122, February.
    8. Hans-Helmut Knig & Oliver H. Gnther & Matthias C. Angermeyer & Christiane Roick, 2009. "Utility Assessment in Patients with Mental Disorders: Validity and Discriminative Ability of the Time Trade-Off Method," PharmacoEconomics, Springer Healthcare | Adis, Springer Healthcare | Adis, vol. 27(5), pages 405-419.
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