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Is “end of life” a special case? Connecting Q with survey methods to measure societal support for views on the value of life‐extending treatments

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  • Helen Mason
  • Marissa Collins
  • Neil McHugh
  • Jon Godwin
  • Job Van Exel
  • Cam Donaldson
  • Rachel Baker

Abstract

Preference elicitation studies reporting societal views on the relative value of end‐of‐life treatments have produced equivocal results. This paper presents an alternative method, combining Q methodology and survey techniques (Q2S) to determine the distribution of 3 viewpoints on the relative value of end‐of‐life treatments identified in a previous, published, phase of this work. These were Viewpoint 1, “A population perspective: value for money, no special cases”; Viewpoint 2, “Life is precious: valuing life‐extension and patient choice”; and Viewpoint 3, “Valuing wider benefits and opportunity cost: the quality of life and death.” A Q2S survey of 4,902 respondents across the United Kingdom measured agreement with these viewpoints; 37% most agreed with Viewpoint 1, 49% with Viewpoint 2, and 9% with Viewpoint 3. Regression analysis showed associations of viewpoints with gender, level of education, religion, voting preferences, and satisfaction with the NHS. The Q2S approach provides a promising means to investigate how in‐depth views and opinions are represented in the wider population. As demonstrated in this study, there is often more than 1 viewpoint on a topic and methods that seek to estimate that averages may not provide the best guidance for societal decision‐making.

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  • Helen Mason & Marissa Collins & Neil McHugh & Jon Godwin & Job Van Exel & Cam Donaldson & Rachel Baker, 2018. "Is “end of life” a special case? Connecting Q with survey methods to measure societal support for views on the value of life‐extending treatments," Health Economics, John Wiley & Sons, Ltd., vol. 27(5), pages 819-831, May.
  • Handle: RePEc:wly:hlthec:v:27:y:2018:i:5:p:819-831
    DOI: 10.1002/hec.3640
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    References listed on IDEAS

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    1. Mason, Helen & van Exel, Job & Baker, Rachel & Brouwer, Werner & Donaldson, Cam, 2016. "From representing views to representativeness of views: Illustrating a new (Q2S) approach in the context of health care priority setting in nine European countries," Social Science & Medicine, Elsevier, vol. 166(C), pages 205-213.
    2. van Exel, Job & Baker, Rachel & Mason, Helen & Donaldson, Cam & Brouwer, Werner, 2015. "Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology," Social Science & Medicine, Elsevier, vol. 126(C), pages 128-137.
    3. Rachel Baker & John Wildman & Helen Mason & Cam Donaldson, 2014. "Q‐Ing For Health—A New Approach To Eliciting The Public'S Views On Health Care Resource Allocation," Health Economics, John Wiley & Sons, Ltd., vol. 23(3), pages 283-297, March.
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    1. Reckers-Droog, Vivian & Jansen, Maarten & Bijlmakers, Leon & Baltussen, Rob & Brouwer, Werner & van Exel, Job, 2020. "How does participating in a deliberative citizens panel on healthcare priority setting influence the views of participants?," Health Policy, Elsevier, vol. 124(2), pages 143-151.
    2. McHugh, Neil & Pinto-Prades, José Luis & Baker, Rachel & Mason, Helen & Donaldson, Cam, 2020. "Exploring the relative value of end of life QALYs: Are the comparators important?," Social Science & Medicine, Elsevier, vol. 245(C).

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