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The importance of age in allocating health care resources: does intervention-type matter?

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  • Mira Johri
  • Laura J. Damschroder
  • Brian J. Zikmund-Fisher
  • Peter A. Ubel

Abstract

Background: Recent proposals to reform cost-effectiveness analysis (CEA) by weighting health benefits [(Quality-adjusted life-years) QALYs] by recipients' age are based on studies examining age-related preferences in life-saving contexts. We investigated whether the perceived importance of age in resource allocation decisions differs among intervention-types. Methods: 160 individuals were recruited from a cafeteria of a university medical centre and asked to choose between hypothetical health care programmes. Scenario A described two programmes treating life-threatening conditions and Scenario B two programmes providing palliative care. Programmes were identical except in average patient age (35 versus 65). Respondents also directly rated the importance of age for allocating resources for six types of interventions. Results: Responses for the life-saving scenario favoured younger age groups while those for the palliative care scenario showed no age preference. The difference between scenarios was statistically significant. When directly rating the importance of age in allocating treatment resources, people placed greatest importance on age in treating infertility and life-saving, and least importance in treating depression. Discussion: The importance people place on age as a resource allocation criterion depends on the clinical context. As QALYs serve as a common measure of health benefits for all intervention types, age weighting of QALYs is premature. Copyright © 2004 John Wiley & Sons, Ltd.

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  • 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.
  • Handle: RePEc:wly:hlthec:v:14:y:2005:i:7:p:669-678
    DOI: 10.1002/hec.958
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    References listed on IDEAS

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    Cited by:

    1. Gill, Betty & Griffin, Barbara & Hesketh, Beryl, 2013. "Changing expectations concerning life-extending treatment: The relevance of opportunity cost," Social Science & Medicine, Elsevier, vol. 85(C), pages 66-73.
    2. Benning, Tim M. & Dellaert, Benedict G.C., 2013. "Paying more for faster care? Individuals' attitude toward price-based priority access in health care," Social Science & Medicine, Elsevier, vol. 84(C), pages 119-128.
    3. Lancsar, Emily & Wildman, John & Donaldson, Cam & Ryan, Mandy & Baker, Rachel, 2011. "Deriving distributional weights for QALYs through discrete choice experiments," Journal of Health Economics, Elsevier, vol. 30(2), pages 466-478, March.

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