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On the societal value of health care: what do we know about the person trade-off technique?

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  • Colin Green

    (MEDTAP International, 20 Bloomsbury Square, London, UK)

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    Abstract

    The person trade-off (PTO) technique has been suggested as a means of eliciting social preferences for health care, both the valuation of health care interventions and, more recently, to inform on the weights that society may attach to other decision-making criteria (e.g. the severity of a patients pre-treatment condition). Given the increased attention afforded to the PTO technique, this review examines the current evidence to inform on the ability of the PTO to provide a measure of social preference. Applying criteria of practicality, reliability and validity to empirical and theoretical contributions to the PTO literature, the review finds that the technique has limited empirical support. Applications of the PTO have been in a largely experimental setting, the reliability of the PTO is unproven and the empirical validity of the technique, in terms its ability to reflect actual preferences, remains unclear. In the broader context of the valuation of health states or outcomes, all techniques are open to criticism. Given this position, the review finds support for the potential of the PTO in the assessment of the societal value of health care, and it supports further empirical inquiry on the PTO. Copyright © 2001 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.581
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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 10 (2001)
    Issue (Month): 3 ()
    Pages: 233-243

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    Handle: RePEc:wly:hlthec:v:10:y:2001:i:3:p:233-243

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    References

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    1. Charny, M.C. & Lewis, P.A. & Farrow, S.C., 1989. "Choosing who shall not be treated in the NHS," Social Science & Medicine, Elsevier, vol. 28(12), pages 1331-1338, January.
    2. Ubel, Peter A. & Loewenstein, George & Scanlon, Dennis & Kamlet, Mark, 1998. "Value measurement in cost-utility analysis: explaining the discrepancy between rating scale and person trade-off elicitations," Health Policy, Elsevier, vol. 43(1), pages 33-44, January.
    3. Nord, Erik, 1993. "The trade-off between severity of illness and treatment effect in cost-value analysis of health care," Health Policy, Elsevier, vol. 24(3), pages 227-238, August.
    4. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
    5. Jose-Luis Pinto Prades, 1997. "Is the Person Trade-off a Valid Method for Allocating Health Care Resources?," Health Economics, John Wiley & Sons, Ltd., vol. 6(1), pages 71-81.
    6. Dolan, Paul, 1998. "The measurement of individual utility and social welfare," Journal of Health Economics, Elsevier, vol. 17(1), pages 39-52, January.
    7. Ubel, Peter A., 1999. "How stable are people's preferences for giving priority to severely ill patients?," Social Science & Medicine, Elsevier, vol. 49(7), pages 895-903, October.
    8. Richardson, J., 1994. "Cost utility analysis: What should be measured?," Social Science & Medicine, Elsevier, vol. 39(1), pages 7-21, July.
    9. Ubel, Peter A. & Richardson, Jeff & Baron, Jonathan, 2002. "Exploring the role of order effects in person trade-off elicitations," Health Policy, Elsevier, vol. 61(2), pages 189-199, August.
    10. Paul Dolan & Colin Green, 1998. "Using the person trade-off approach to examine differences between individual and social values," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 307-312.
    11. 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.
    12. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the 'Fair Innings' Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132.
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    Cited by:
    1. Edward C. Mansley & Elamin H. Elbasha, 2003. "Preferences and person trade-offs: forcing consistency or inconsistency in health-related quality of life measures?," Health Economics, John Wiley & Sons, Ltd., vol. 12(3), pages 187-198.
    2. Ryan, Mandy & Scott, David A. & Donaldson, Cam, 2004. "Valuing health care using willingness to pay: a comparison of the payment card and dichotomous choice methods," Journal of Health Economics, Elsevier, vol. 23(2), pages 237-258, March.
    3. Lars Østerdal, 2009. "The lack of theoretical support for using person trade-offs in QALY-type models," The European Journal of Health Economics, Springer, vol. 10(4), pages 429-436, October.

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