VALUE MEASUREMENT IN CEA: FAIRNESS TO ELDERLY/DISABLED

CEA 的价值衡量：对老年人/残疾人的公平

• 批准号: 6387730
• 负责人: PETER A UBEL
• 金额: $ 32.17万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-05-01 至 2004-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6387730
• 关键词: clinical research; cost effectiveness; geriatrics; health care cost /financing; health care policy; health care service evaluation; health services research tag; human old age (65+); human subject; interview; person with disability; population survey; socioeconomics

DESCRIPTION (adapted from the Abstract): Cost-effectiveness analysis (CEA) has been criticized for discriminating against people with disabilities, for harming the elderly, for ignoring issues of fairness, and for undervaluing the benefit of treating severely ill patients. Because the elderly often have chronic disabilities that limit the amount they can improve their quality of life with health programs, measures of the cost-effectiveness of programs targeted toward the elderly appear relatively unfavorable. We think that these problems can be overcome by distinguishing between the health related utility brought by health care programs and the societal value of those programs. The goal is to improve value measurement in CEA to make it fair to the elderly and people with disabilities. To achieve this goal, we plan to test and refine the person trade-off method (PTO) - a measure of the societal value of health care programs. In a typical PTO elicitation, a subject is asked how many people need to be cured of a health condition (e.g., severe osteoarthritis) to equal the benefit of saving ten people's lives. Several methodologic issues have arisen about the feasibility of PTO measurement. In a series of six studies, we will explore these methodologic issues as well as the cognitive processes people undergo when responding to PTO elicitations. The team proposes to conduct PTO eliciatations from the general public using face to face interviews. The primary source of subjects will be prospective jurors at the Philadelphia County and Montgomery County Courthouses and mall patrons from the Delaware Valley area. Studies 1 and 2 will explore way to improve the consistency of PTO responses. Study 3 will explore the societal value people place on preventive versus curative treatment programs. Study 4 will evaluate whether CEA undervalues treatment programs directed at saving the lives of people with chronic disabilities. Study 5 will test whether the importance people place on equity in responding to PTO elicitations is unduly influenced by cognitive biases resulting from framing effects. Study 6 will explore whether the value people place on treatment programs depends on patients' ages, and whether the importance they place on age varies across treatment programs (e.g., life saving programs versus programs that improve function or reduce pain). The goal is to evaluate whether PTO determinations can be an effective solution to the problems that arise when conventional utility assessment is applied to the evaluation of health care programs for the elderly and disabled.

描述（改编自摘要）：成本效益分析 (CEA) 已 因歧视残疾人而受到批评 伤害老年人、忽视公平问题、低估老年人的价值 对治疗重症患者有好处。 因为老年人常常有 慢性残疾限制了他们提高生活质量的能力 生活与健康计划、计划成本效益的衡量 针对老年人则显得相对不利。 我们认为 这些问题可以通过区分健康相关的问题来解决 医疗保健计划带来的效用及其社会价值 程序。 目标是改进 CEA 的价值衡量，使其公平 老年人和残疾人。 为了实现这一目标，我们计划 测试并完善人员权衡方法（PTO）——一种社会衡量标准 医疗保健计划的价值。 在典型的 PTO 启发中，主题是 询问有多少人的健康状况需要治愈（例如，严重的 骨关节炎）相当于拯救十个人的生命。 一些 关于 PTO 测量的可行性出现了方法学问题。 在 一系列六项研究，我们将探讨这些方法论问题以及 人们在响应 PTO 诱导时所经历的认知过程。 该团队建议使用 PTO 向公众进行启发 面对面采访。 主题的主要来源将是前瞻性的 费城县和蒙哥马利县法院和购物中心的陪审员 来自特拉华谷地区的顾客。 研究 1 和 2 将探索方法 提高 PTO 响应的一致性。 研究 3 将探讨社会 人们对预防性治疗方案与治疗性治疗方案的重视程度。 研究4 将评估 CEA 是否低估了旨在挽救生命的治疗计划 慢性残疾人的生活。 研究 5 将测试是否 人们在回应 PTO 启发时过分重视公平性 受框架效应产生的认知偏差的影响。 研究 6 将 探讨人们对治疗方案的重视是否取决于 患者的年龄，以及他们对年龄的重视程度是否因人而异 治疗计划（例如，挽救生命的计划与改善生命的计划） 发挥作用或减轻疼痛）。 目标是评估 PTO 决定是否 可以有效解决传统方法使用时出现的问题 效用评估应用于医疗保健计划的评估 老年人和残疾人。