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Sensitivity and perspective in the valuation of health status: whose values count?


Author Info

  • G. Ardine De Wit
  • Jan J.V. Busschbach

    (Institute for Medical Technology Assessment, Erasmus University, Rotterdam, Netherlands)

  • Frank Th. De Charro

    (Center for Health Policy and Law, Erasmus University, Rotterdam, Netherlands)

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    The literature was studied on the existence of differences in valuation for hypothetical and actual health states between patients and other-rater groups. It was found that nine different study designs have been used to study this question and two of these designs were applied in a study involving dialysis patients and other rater groups. In the first study, both dialysis patients and students had to value hypothetical health states with Standard Gamble (SG) and Time Trade Off (TTO). Patients assigned higher values to hypothetical health states than students did. In the second study, dialysis patients who were being treated with four different dialysis modalities were asked to value their own health state with SG, TTO and a visual analogue scale (EQ VAS ), and to describe their health state on the EQ-5D profile . Several EQ-5D index values (health index values derived from general population samples) were calculated for the four dialysis treatment groups, based on the EQ-5D profile . These health indexes could discriminate between treatment groups, according to clinical impressions. Treatment groups could not be differentiated based on patients' valuations of own health state. The results suggest that general population samples, using EQ-5D index values, may be more able to discriminate between patient groups than the patients themselves are. The implications of this finding for valuation research and policy-making are discussed. Copyright © 2000 John Wiley & Sons, Ltd.

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    Bibliographic Info

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

    Volume (Year): 9 (2000)
    Issue (Month): 2 ()
    Pages: 109-126

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    Handle: RePEc:wly:hlthec:v:9:y:2000:i:2:p:109-126

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    1. John C. Hershey & Howard C. Kunreuther & Paul J. H. Schoemaker, 1982. "Sources of Bias in Assessment Procedures for Utility Functions," Management Science, INFORMS, vol. 28(8), pages 936-954, August.
    2. Niklas Zethraeus & Magnus Johannesson, 1999. "A comparison of patient and social tariff values derived from the time trade-off method," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 541-545.
    3. Busschbach, Jan J. V. & McDonnell, Joseph & Essink-Bot, Marie-Louise & van Hout, Ben A., 1999. "Estimating parametric relationships between health description and health valuation with an application to the EuroQol EQ-5D," Journal of Health Economics, Elsevier, vol. 18(5), pages 551-570, October.
    4. Hall, Jane & Gerard, Karen & Salkeld, Glenn & Richardson, Jeff, 1992. "A cost utility analysis of mammography screening in Australia," Social Science & Medicine, Elsevier, vol. 34(9), pages 993-1004, May.
    5. Nord, Erik, 1992. "Methods for quality adjustment of life years," Social Science & Medicine, Elsevier, vol. 34(5), pages 559-569, March.
    6. Essink-Bot, Marie-Louise & Bonsel, Gouke J. & van der Maas, Paul J., 1990. "Valuation of health states by the general public: Feasibility of a standardized measurement procedure," Social Science & Medicine, Elsevier, vol. 31(11), pages 1201-1206, January.
    7. Hadorn, David C., 1991. "The role of public values in setting health care priorities," Social Science & Medicine, Elsevier, vol. 32(7), pages 773-781, January.
    8. Jenkinson, Crispin & Fitzpatrick, Ray & Argyle, Michael, 1988. "The Nottingham health profile: An analysis of its sensitivity in differentiating illness groups," Social Science & Medicine, Elsevier, vol. 27(12), pages 1411-1414, January.
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    Cited by:
    1. Han Bleichrodt & José Luis Pinto & José María Abellán-Perpiñán, 2003. "A consistency test of the time trade-off," Economics Working Papers 676, Department of Economics and Business, Universitat Pompeu Fabra.
    2. Ada Ferrer-i-Carbonell & Bernard M.S. van Praag, 2002. "The Subjective Costs of Health Losses due to Chronic Diseases," Tinbergen Institute Discussion Papers 02-023/3, Tinbergen Institute.
    3. Bleichrodt, Han & Filko, Martin, 2008. "New tests of QALYs when health varies over time," Journal of Health Economics, Elsevier, vol. 27(5), pages 1237-1249, September.
    4. Begoña Álvarez & Eva Rodríguez-Míguez, 2009. "Patients’ self-interest bias: Empirical evidence from a priority-setting experiment," Working Papers 0903, Universidade de Vigo, Departamento de Economía Aplicada.
    5. Thébaut, Clémence, 2013. "Dealing with moral dilemma raised by adaptive preferences in health technology assessment: The example of growth hormones and bilateral cochlear implants," Social Science & Medicine, Elsevier, vol. 99(C), pages 102-109.
    6. Ada Ferrer-i-Carbonell & Bernard M. S. van Praag, 2001. "The Subjective Costs of Health Losses Due to Chronic Diseases: An Alternative Model for Monetary Appraisal," Discussion Papers of DIW Berlin 262, DIW Berlin, German Institute for Economic Research.
    7. Rachel Mann & John Brazier & Aki Tsuchiya, 2009. "A comparison of patient and general population weightings of EQ-5D dimensions," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 363-372.
    8. William Hollingworth & Richard A. Deyo & Sean D. Sullivan & Scott S. Emerson & Darryl T. Gray & Jeffrey G. Jarvik, 2002. "The practicality and validity of directly elicited and SF-36 derived health state preferences in patients with low back pain," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 71-85.
    9. Ferrer-i-Carbonell, Ada & van Praag, Bernard M. S., 2001. "The Subjective Costs of Health Losses due to Chronic Diseases: An Alternative Model Appraisal," IZA Discussion Papers 313, Institute for the Study of Labor (IZA).
    10. Stein, K & Dyer, M & Crabb, T & Milne, R & Round, A & Ratcliffe, J & Brazier, J, 2006. "An Internet “Value of Health” panel: recruitment, participation and compliance," MPRA Paper 29770, University Library of Munich, Germany.
    11. José M. Labeaga & Xisco Oliver & Amedeo Spadaro, . "Measuring Changes in Health Capital," Working Papers 2005-15, FEDEA.


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