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Age-related preferences and age weighting health benefits

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  • Tsuchiya, Aki

Abstract

This paper deals with the relevance of age in the paradigm of quality adjusted life years (QALYs). The first section outlines two rationales for incorporating age weights into QALYs. One of them is based on efficiency concerns; and the other on equity concerns. Both of these are theoretical constructs. The main purpose of this paper is to examine the extent of published empirical support for such age weighting. The second section is a brief survey of nine empirical studies that elicited age-related preferences from the general public. Six of these quantified the strength of the preferences, and these are discussed in more detail in the third section. The analysis distinguishes three kinds of age-related preference: productivity ageism, utilitarian ageism and egalitarian ageism. The relationship between them and their relevance to the two different rationales for age weighting are then explored. It is concluded that, although there is strong prima facie evidence of public support for both types of age weighting, the empirical evidence to support any particular set of weights is at present weak.

Suggested Citation

  • Tsuchiya, Aki, 1999. "Age-related preferences and age weighting health benefits," Social Science & Medicine, Elsevier, vol. 48(2), pages 267-276, January.
  • Handle: RePEc:eee:socmed:v:48:y:1999:i:2:p:267-276
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    Citations

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    Cited by:

    1. 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.
    2. repec:eee:hepoli:v:121:y:2017:i:8:p:913-922 is not listed on IDEAS
    3. Mira Johri & Laura J. Damschroder & Brian J. Zikmund-Fisher & Peter A. Ubel, 2005. "The importance of age in allocating health care resources: does intervention-type matter?," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 669-678.
    4. Anabela Botelho & Lina Sofia Lourenço-Gomes & Lígia Costa Pinto, 2013. "Consumer preferences for apple: Comparing the results of contingent valuation method and a real purchasing situation," NIMA Working Papers 51, Núcleo de Investigação em Microeconomia Aplicada (NIMA), Universidade do Minho.
    5. Rob Baltussen & Elly Stolk & Dan Chisholm & Moses Aikins, 2006. "Towards a multi-criteria approach for priority setting: an application to Ghana," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 689-696.
    6. Gyrd-Hansen, Dorte, 2004. "Investigating the social value of health changes," Journal of Health Economics, Elsevier, vol. 23(6), pages 1101-1116, November.
    7. Jaldell Henrik, 2013. "Cost-benefit analyses of sprinklers in nursing homes for elderly," Journal of Benefit-Cost Analysis, De Gruyter, vol. 4(2), pages 209-235, August.
    8. Liesbet Wetering & Job Exel & Ana Bobinac & Werner Brouwer, 2015. "Valuing QALYs in Relation to Equity Considerations Using a Discrete Choice Experiment," PharmacoEconomics, Springer, vol. 33(12), pages 1289-1300, December.
    9. Eva Rodríguez & José Luis Pinto, 2000. "The social value of health programmes: is age a relevant factor?," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 611-621.
    10. Arnesen, Trude & Kapiriri, Lydia, 2004. "Can the value choices in DALYs influence global priority-setting?," Health Policy, Elsevier, vol. 70(2), pages 137-149, November.
    11. Aki Tsuchiya, 2000. "QALYs and ageism: philosophical theories and age weighting," Health Economics, John Wiley & Sons, Ltd., vol. 9(1), pages 57-68.
    12. repec:eee:transa:v:106:y:2017:i:c:p:333-349 is not listed on IDEAS
    13. Shah, K. & Chapman, A. & Devlin, N. & Barnsley, P., 2015. "Do Respondents Completing Abstract, Hypothetical Priority-setting Exercises Agree With the Policy Implications of Their Choices?," Consulting Reports 001576, Office of Health Economics.
    14. Robberstad, Bjarne & Norheim, Ole F., 2011. "Incorporating concerns for equal lifetime health in evaluations of public health programs," Social Science & Medicine, Elsevier, vol. 72(10), pages 1711-1716, May.
    15. Richardson, Jeff & Sinha, Kompal & Iezzi, Angelo & Maxwell, Aimee, 2012. "Maximising health versus sharing: Measuring preferences for the allocation of the health budget," Social Science & Medicine, Elsevier, vol. 75(8), pages 1351-1361.
    16. Stolk, Elly A. & Pickee, Stefan J. & Ament, Andre H.J.A. & Busschbach, Jan J.V., 2005. "Equity in health care prioritisation: An empirical inquiry into social value," Health Policy, Elsevier, vol. 74(3), pages 343-355, November.
    17. Erdem, Seda & Campbell, Danny & Thompson, Carl, 2014. "Elimination and selection by aspects in health choice experiments: Prioritising health service innovations," Journal of Health Economics, Elsevier, vol. 38(C), pages 10-22.
    18. 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.
    19. Erdem, Seda & Campbell, Danny & Thompson, Carl, 2014. "Addressing elimination and selection by aspects decision rules in discrete choice experiments: does it matter?," 2014 Annual Meeting, July 27-29, 2014, Minneapolis, Minnesota 169839, Agricultural and Applied Economics Association.
    20. Baltussen, Rob, 2006. "Priority setting of public spending in developing countries: Do not try to do everything for everybody," Health Policy, Elsevier, vol. 78(2-3), pages 149-156, October.
    21. Elamin H. Elbasha, 2000. "Discrete time representation of the formula for calculating DALYs," Health Economics, John Wiley & Sons, Ltd., vol. 9(4), pages 353-365.
    22. Richardson, Jeff & McKie, John, 2005. "Empiricism, ethics and orthodox economic theory: what is the appropriate basis for decision-making in the health sector?," Social Science & Medicine, Elsevier, vol. 60(2), pages 265-275, January.

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