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Does the use of the proportional shortfall help align the prioritisation of health services with public preferences?

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Abstract

It has been proposed that equity may be included in the economic evaluation of health services using the ‘proportional shortfall’ (PS)—the proportion of a person’s QALY expectation that they would lose because of an illness. The present paper reports the results of a population survey designed to test whether PS helped to explain people’s preferences for health services and whether it did this better than the absolute shortfall or the equity related variables that PS seeks to replace. Survey respondents were asked to allocate 100 votes between 13 scenarios and a standard scenario. Variation in the allocation of votes was explained by health gain and different combinations of the equity variables. Differences in votes for the comparisons were significantly related to differences in PS but the relationship was weaker than between votes and the age related variables. Cases were identified where PS suggested a priority ordering of services which was strongly rejected by respondents. It is concluded that the use of PS is unlikely to improve the alignment of priorities with public preferences.

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References

  1. Stolk, E.A., van Donselaar, G., Brouwer, W.B., Busschbach, J.: Reconciliation of economic concerns and health policy. Pharmacoeconomics. 22, 1097–1107 (2004)

    Article  PubMed  Google Scholar 

  2. van de Wetering, E.J., Stolk, E.A., van Exel, N.J.A., Brouwer, W.B.: Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall. Eur J Health Econ. 14, 107–115 (2013)

    Article  PubMed  Google Scholar 

  3. Stolk, E.A., Pickee, S.J., Ament, A.H., Busschbach, J.: Equity in healthcare prioritisation: an empirical inquiry into social value. Health Policy 74, 343–355 (2005)

    Article  PubMed  Google Scholar 

  4. Mott, D.: Value based assessment: the case for proportional shortfall. Health Econonics Group. https://blogs.ncl.ac.uk/healtheconomicsgroup/2014/10/page/2/ Newcastle University. Accessed 3 May 2017

  5. Kusel, J., Beale, R.C., Maruszczak, M.: Implications of the inter-relatedness of the proportional and absolute QALY shortfall measurements for disease burden. In: ISPOR 20th Annual International Meeting Research Abstracts. Value Health. A15, Philadelphia (2015)

  6. Skedgel, C., Regier, D.A.: Constant-sum paired comparisons for eliciting stated preferences: a tutorial. Patient. 8, 155–163 (2015)

    Article  PubMed  Google Scholar 

  7. Ryan, M., Scott, D.A., Reeves, C., Bate, A., van Teijlingen, E.R., Russell, E.M.: Eliciting public preferences for healthcare: a systematic review of techniques. Health Technol Assess (Winchester, England). 5, 1–186 (2001)

    CAS  Google Scholar 

  8. Carson, R., Louviere, J.: A common nomenclature for stated preference elicitation approaches. Environ. Resour Econ. 49, 539–559 (2011)

    Article  Google Scholar 

  9. Louviere, J.J., Hensher, D.A., Swait, J.D.: Conjoint preference elicitation methods in the broader context of random utility theory. In: Gustafsson, A., Herrmann, A., Huber, F. (eds.) Conjoint measurement: methods and applications, pp. 167–198. Springer, Berlin (2000)

    Google Scholar 

  10. Estimated resident population (ERP) by region, age and sex 2001-2013. Australian Bureau of Statistics http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3101.0Mar%202015?Open. Accessed 23 July 2015

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Acknowledgements

Financial support for this study was provided entirely by a grant from the National Health and Medical Research Council (NH&MRC) project Grant ID 1069241 Measuring health related social preferences and their inclusion in an alternative formula for prioritising health services.

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Authors and Affiliations

  1. Centre for Health Economics, Level 2, 15 Innovation Walk, Monash Business School, Monash University, Clayton, VIC, 3800, Australia

    Jeff Richardson, Angelo Iezzi, Aimee Maxwell & Gang Chen

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  1. Jeff Richardson
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  2. Angelo Iezzi
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  3. Aimee Maxwell
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  4. Gang Chen
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Correspondence to Jeff Richardson.

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Richardson, J., Iezzi, A., Maxwell, A. et al. Does the use of the proportional shortfall help align the prioritisation of health services with public preferences?. Eur J Health Econ 19, 797–806 (2018). https://doi.org/10.1007/s10198-017-0923-5

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  • DOI: https://doi.org/10.1007/s10198-017-0923-5

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