The importance of age in allocating health care resources: does intervention-type matter?
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.
Volume (Year): 14 (2005)
Issue (Month): 7 ()
|Contact details of provider:|| Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749|
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Busschbach, Jan J. V. & Hessing, Dick J. & De Charro, Frank Th., 1993. "The utility of health at different stages in life: A quantitative approach," Social Science & Medicine, Elsevier, vol. 37(2), pages 153-158, July.
- Tsuchiya, Aki, 1999. "Age-related preferences and age weighting health benefits," Social Science & Medicine, Elsevier, vol. 48(2), pages 267-276, January.
- Eva Rodríguez-Míguez & José Luis Pinto, 1999.
"The social value of health programs: Is age a relevant factor?,"
9904, Universidade de Vigo, Departamento de Economía Aplicada.
- Eva Rodríguez & José Luis Pinto, 2000. "The social value of health programs: Is age a relevant factor?," Economics Working Papers 473, Department of Economics and Business, Universitat Pompeu Fabra.
- Eva Rodríguez & José Luis Pinto, 2000. "The social value of health programs: Is age a relevant factor?," Working Papers, Research Center on Health and Economics 473, Department of Economics and Business, Universitat Pompeu Fabra.
- Meltzer, David, 1997. "Accounting for future costs in medical cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 33-64, February.
- Cropper, Maureen L & Aydede, Sema K & Portney, Paul R, 1994. "Preferences for Life Saving Programs: How the Public Discounts Time and Age," Journal of Risk and Uncertainty, Springer, vol. 8(3), pages 243-265, May.
- Donaldson, Cam & Atkinson, Ann & Bond, John & Wright, Ken, 1988. "Should QALYs be programme-specific?," Journal of Health Economics, Elsevier, vol. 7(3), pages 239-257, September.
- Tsuchiya, Aki & Dolan, Paul & Shaw, Rebecca, 2003. "Measuring people's preferences regarding ageism in health: some methodological issues and some fresh evidence," Social Science & Medicine, Elsevier, vol. 57(4), pages 687-696, August.
- David Meltzer, 1997. "Accounting for Future Costs in Medical Cost-Effectiveness Analysis," NBER Working Papers 5946, National Bureau of Economic Research, Inc.
- Johannesson, Magnus & Johansson, Per-Olov, 1997. "Is the valuation of a QALY gained independent of age? Some empirical evidence," Journal of Health Economics, Elsevier, vol. 16(5), pages 589-599, October.
- Garber, Alan M. & Phelps, Charles E., 1997. "Economic foundations of cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 16(1), pages 1-31, February.
- 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.
- Alan Williams, 1997. "Intergenerational Equity: An Exploration of the 'Fair Innings' Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132.
- Charny, M.C. & Lewis, P.A. & Farrow, S.C., 1989. "Choosing who shall not be treated in the NHS," Social Science & Medicine, Elsevier, vol. 28(12), pages 1331-1338, January.
- Julie Ratcliffe, 2000. "Public preferences for the allocation of donor liver grafts for transplantation," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 137-148.
- Alan Shiell & Penelope Hawe & Janelle Seymour, 1997. "Values and preferences are not necessarily the same," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 515-518.
- 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.
- Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Maximizing health benefits vs egalitarianism: An Australian survey of health issues," Social Science & Medicine, Elsevier, vol. 41(10), pages 1429-1437, November. Full references (including those not matched with items on IDEAS)
When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:14:y:2005:i:7:p:669-678. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing)or (Christopher F. Baum)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.