Investigating Choice Experiments for Preferences of Older People (ICEPOP): evaluative spaces in health economics
Investigating Choice Experiments for Preferences of Older People (ICEPOP): evaluative spaces in health economics
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DOI：
10.1258/jhsrp.2008.008024
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发表时间：
2008-10-01
影响因子：
2.4
通讯作者：
Peters, Tim
中科院分区：
文献类型：
--
作者：
Coast, Joanna;Flynn, Terry;Peters, Tim
本文涉及三个问题的评价框架，目前占主导地位的卫生经济学。这些关切是：评估框架完全与健康有关;评估框架只关注患者的个人主义;在当前评估框架内用于估计“健康”的方法可以在描述系统的生成和使用较少依赖于人们在基数上表达其偏好的能力的评估方法方面得到改进。在探讨这些问题时，老年人偏好选择实验调查方案明确地把重点放在老年人的主题和离散选择实验的方法上。已经制定了一个能力指数，目前正在生成用于衡量临终关怀的经济指标，从而有可能将评价框架扩展到保健以外。护理人员经验的衡量标准和将临终护理的衡量标准扩展到亲人的框架也在制定中，从而将评估框架扩展到患者之外。采用迭代方法的严格定性方法已被开发用于构建属性，并已利用最好的最坏的缩放，以降低任务的复杂性，并提供对异质性的见解。在所有这些领域都有一些进一步研究的途径，但特别需要更多地注意卫生经济学评价框架的理论基础。《卫生服务研究与政策杂志》2008年第13期增刊3期：31-37（C）皇家医学会出版社有限公司2008年
This paper deals with three concerns about the evaluative framework that is currently dominant within health economics. These concerns are: that the evaluative framework is concerned entirely with health; that the evaluative framework has an individualistic focus on patients alone; and that the methods used to estimate 'health' within the current evaluative framework could be improved both in terms of the generation of descriptive systems and in using valuation methods that rely less on people's ability to express their preferences on a cardinal scale. In exploring these issues the Investigating Choice Experiments for Preferences of Older People (ICEPOP) programme has explicitly focused on both the topic of older people and the methods of discrete choice experiments. A capability index has been developed and attributes for an economic measure of end-of-life care are currently being generated, providing the possibility of extending the evaluative framework beyond health alone. A measure of carer's experience and a framework for extending measurement in end-of-life care to loved ones are both also in development, thus extending the evaluative framework beyond the patient alone. Rigorous qualitative methods employing an iterative approach have been developed for use in constructing attributes, and best-worst scaling has been utilized to reduce task complexity and provide insights into heterogeneity. There are a number of avenues for further research in all these areas, but in particular there is need for greater attention to be paid to the theory underlying the evaluative framework within health economics. Journal of Health Services Research & Policy Vol 13 Suppl 3, 2008: 31-37 (C) The Royal Society of Medicine Press Ltd 2008