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The influence of subjective life expectancy on health state valuations using a 10 year TTO

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Author Info
F. E. van Nooten (Department of Health Policy & Management, Erasmus University Rotterdam|Erasmus MC, Rotterdam, The Netherlands)
X. Koolman (Department of Health Policy & Management, Erasmus University Rotterdam|Erasmus MC, Rotterdam, The Netherlands)
W. B. F. Brouwer

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Abstract

Aim: To investigate if subjective life expectancy (SLE) impacts the willingness to trade-off (WTT) and the number of years traded-off in a 10-years time trade-off (TTO) exercise to obtain health state valuations.

Methods: An Internet-based questionnaire was administered in a sample representative for the Dutch general public. Next to basic demographic characteristics and SLE, respondents were asked to perform three TTO exercises. The following EQ-5D health states were included 21211 (TTO1), 22221 (TTO2) and 33312 (TTO3). The WTT was studied using a probit regression model. The number of years traded-off was investigated using a generalized negative binomial regression model. The independent variables used in both models were age, gender, quality of life, education, the difference between age and expected age of death (SLE), and a variable indicating whether the SLE was less than 10 years (SLE<10).

Results: Three hundred and thirty nine respondents completed the questionnaire. The mean utility scores were 0.96 (TTO1), 0.94 (TTO2) and 0.79 (TTO3). The probit model showed that SLE was the only variable with a significant influence on WTT. The gnbreg showed that the number of years traded-off was also significantly influenced by SLE. In addition, age and education significantly influenced the number of years traded-off.

Conclusion: The WTT years and the number of years traded-off were both influenced by SLE in 10-years TTO exercises. Reducing remaining life expectancy to 10 years in a TTO may thus increase loss aversion and, especially in respondents losing relatively many expected life years, diminish WTT and the amount of time traded off. Copyright © 2008 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1385
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 18 (2009)
Issue (Month): 5 ()
Pages: 549-558
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Handle: RePEc:wly:hlthec:v:18:y:2009:i:5:p:549-558

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

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Dolan, P. & Gudex, C. & Kind, P. & Williams, A., 1996. "Valuing health states: A comparison of methods," Journal of Health Economics, Elsevier, vol. 15(2), pages 209-231, April. [Downloadable!] (restricted)
  2. Floortje van Nooten & Werner Brouwer, 2004. "The influence of subjective expectations about length and quality of life on time trade-off answers," Health Economics, John Wiley & Sons, Ltd., vol. 13(8), pages 819-823. [Downloadable!]
  3. Han Bleichrodt, 2002. "A new explanation for the difference between time trade-off utilities and standard gamble utilities," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 447-456. [Downloadable!]
  4. Kahneman, Daniel & Tversky, Amos, 1979. "Prospect Theory: An Analysis of Decision under Risk," Econometrica, Econometric Society, vol. 47(2), pages 263-91, March. [Downloadable!] (restricted)
  5. L. M. Lamers & J. McDonnell & P. F. M. Stalmeier & P. F. M. Krabbe & J. J. V. Busschbach, 2006. "The Dutch tariff: results and arguments for an effective design for national EQ-5D valuation studies," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1121-1132. [Downloadable!]
  6. Anne Spencer, 2003. "The TTO method and procedural invariance," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 655-668. [Downloadable!]
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