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

最近的研究表明，人口的社会“偏好”优先事项与卫生政策所暗示的优先事项之间存在显著差异，这些优先事项体现在卫生部门的卫生经济评价中。例如，公众给予重病患者更高的优先权，即使对他们无能为力。研究表明，除其他外，公众还将考虑到一些其他因素，包括预后、健康潜力和问题的社会背景。他们不会按照经济理论和实践建议的方式来处理项目成本。这些问题在世卫组织的《卫生系统评价》（2000年世界卫生报告）中得到了突出阐述。健康改善的权重仅为0.25，公平问题的权重为0.75。拟议的研究将执行三个任务。第一个是衡量澳大利亚与健康有关的社会偏好的重要性，这有可能被纳入经济评估研究。关键价值——参数——包括时间偏好率和为多活一年支付费用的社会意愿——将被精确地衡量以供即时使用。其次，包括疾病严重程度、适应性和预后在内的其他问题的重要性将被测试，以确定如何将这些因素纳入健康计划的经济评估。最后，将调查与公共与私人资金、平均主义和选择有关的一些一般问题。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.