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Measuring concerns for severity: Re-examination of a health scale with purported equal interval properties


  • Nord, Erik


Severity of illness is an important official criterion for priority setting in health care in a number of jurisdictions. An 8-point scale of severity and functional status has been used in a number of studies in Norway in order to estimate the strength of concerns for severity in population samples. The scale has attracted international attention and may be of interest to researchers in other countries. For confidence in interpretations of results, the scale should have equal interval properties with respect to individual utility. Close examination suggest that some deviations from equal intervals occur. These deviations do not impact significantly on earlier findings and do not prevent the scale from being a potentially useful tool in future studies of the strength of societal concerns for fairness in health care. However, further research with larger and more representative samples is encouraged.

Suggested Citation

  • Nord, Erik, 2012. "Measuring concerns for severity: Re-examination of a health scale with purported equal interval properties," Health Policy, Elsevier, vol. 105(2), pages 312-316.
  • Handle: RePEc:eee:hepoli:v:105:y:2012:i:2:p:312-316
    DOI: 10.1016/j.healthpol.2012.02.017

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    References listed on IDEAS

    1. Shah, Koonal K., 2009. "Severity of illness and priority setting in healthcare: A review of the literature," Health Policy, Elsevier, vol. 93(2-3), pages 77-84, December.
    2. E. Wetering & E. Stolk & N. Exel & W. Brouwer, 2013. "Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 107-115, February.
    3. David Parkin & Nancy Devlin, 2006. "Is there a case for using visual analogue scale valuations in cost-utility analysis?," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 653-664.
    4. Erik Nord & Anja Undrum Enge & Veronica Gundersen, 2010. "QALYs: is the value of treatment proportional to the size of the health gain?," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 596-607.
    5. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208.
    6. 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.
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