Empirical Ethics: Quantification of Social Preferences for Economic Evaluation in the Health Sector

最近的研究表明，社会“偏好”-人口的优先事项与卫生政策所暗示的优先事项以及卫生部门的卫生经济评价所体现的优先事项之间存在着重大差异。举例来说，市民会优先照顾病情严重的病人，即使对他们无能为力。这些研究表明，除其他外，公众还将考虑一些其他因素，包括预后、健康潜力和问题的社会背景。他们不会以经济理论和实践所推荐的方式来处理项目成本。世卫组织的《卫生系统评价》（2000年世界卫生报告）突出了这些问题。这只给健康改善分配了0.25的权重，给公平问题分配了0.75的权重。拟议的研究将执行三项任务。第一个是衡量澳大利亚健康相关的社会偏好的重要性，应该，潜在的，被列入经济评估研究。关键值-参数-包括时间偏好率和社会愿意支付额外一年的生活将被精确测量，以立即使用。其次，其他问题的重要性，包括疾病的严重程度，适应和预后将进行测试，以确定这些因素应如何包括在卫生计划的经济评价。最后，将调查与公共与私人资助、平等主义和选择相关的一些一般问题。访谈和调查的结果将纳入生活质量评估工具及其用户手册。

Recent studies indicate that there are significant differences between the social 'preferences'-priorities of the population and the priorities implied by health policy and embodied in health economic evaluations of the health sector. For example, members of the public give higher priority to the severely ill even when little can be done for them. The studies suggest that the public would also take into account, inter alia, a number of other factors, including prognosis, health potential and the social context of the problem. They would not treat program costs in the way economic theory and practice recommends. These issues have been dramatised in the WHO's Evaluation of Health Systems (World Health Report 2000). This assigns a weight of only 0.25 to health improvement and 0.75 to issues of fairness. The proposed study will carry out three tasks. The first is to measure the importance of Australian health-related social preferences which should, potentially, be included in economic evaluation studies. Key values - parameters - including the rate of time preference and the social willingness to pay for an additional year of life will be measured precisely for immediate use. Secondly, the importance of other issues including illness severity, adaptation and prognosis will be tested to determine how these factors should be included in the economic evaluation of health programs. Finally, some general issues related to public versus private funding, egalitarianism and choice will be investigated. Results from interviews and surveys will be integrated in the Assessment of Quality of Life (AQoL) instrument and its user manual.