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- Title
Are some QALYs more equal than others?
- Authors
Wetering, E.; Exel, N.; Rose, J.; Hoefman, R.; Brouwer, W.; van de Wetering, E J; van Exel, N J A; Rose, J M; Hoefman, R J; Brouwer, W B F
- Abstract
Including societal preferences in allocation decisions is an important challenge for the health care sector. Here, we present results of a phased discrete choice experiment investigating the impact of various attributes on respondents' preferences for distribution of health and health care. In addition to the renowned equity principles severity of illness (operationalized as initial health) and fair innings (operationalized as age), some characteristics of beneficiaries (culpability and having dependents) and the disease (rarity) were included in the choice experiment. We used a nested logit model to analyse the data. We found that all selected attributes significantly influenced respondents' choices. The phased inclusion showed that additional attributes affected respondents' preferences for previously-included attributes and reduced unobserved variance. Although not all these attributes may be considered relevant for decision making from a normative perspective, including them in choice experiments contributes to our understanding of societal preferences for each single attribute.
- Subjects
MEDICAL care; DECISION making; DISCRETE choice models; PUBLIC health; DISEASES; COMPARATIVE studies; MATHEMATICAL models; RESEARCH methodology; MEDICAL cooperation; PATIENT satisfaction; QUALITY of life; RESEARCH; RESOURCE allocation; THEORY; EVALUATION research; QUALITY-adjusted life years
- Publication
European Journal of Health Economics, 2016, Vol 17, Issue 2, p117
- ISSN
1618-7598
- Publication type
journal article
- DOI
10.1007/s10198-014-0657-6