The economics of measuring quality of life by the standard gamble method

Eric EISENSTAT, Manuela EPURE, Patrick Francis GRAY

Abstract


Of the countless methods for measuring the quality of life (QOL) that have been proposed and analyzed by the vast, multi-disciplinary literature over the past decades, only a select few are alluded to in Romanian scientific circles, and even fewer are actually implemented in practical applications. In adapting existing techniques and engineering a viable measurement system specific to Romania, there exists an important opportunity to re-evaluate the merits and shortcomings of established approaches. As a specific example, we consider the Standard Gamble (SG) method of eliciting “subjective utilities” related to particular health states. The re-evaluation is accomplished from three perspectives: theoretic consistency, interpretability and practicality. It is demonstrated that consistent with economic theory, the appropriate interpretation of SG derived measures is that of a Hicksian change in welfare valuation, rather than a cardinal measure of preferences. A practical consequence of the latter is that SG will necessarily produce a higher QOL value for individuals exhibiting more risk aversion. This leads us to contemplate that in fact SG may be a more appropriate methodology in other contexts, not necessarily health-related, where quality of life may indeed be correlated with the willingness to take risks.

 


Keywords


quality of life, measurement, cost-effectiveness analysis, von Neumann-Morgenstern utilities, Romanian well-being index

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References


• Ardelean, L., C. Lupas, D. Spatarel, and M. Stoleru (2009), Calitatea vieţii la personalul din domeniul sanătăţii mintale. Revista de Neurologieşi Psihiatrie a Copilului şi Adolescentului din România 12(4), 54-64.

• Basu, A., W. Dale, A. Elstein, and D. Meltzer (2009), A linear index for predicting joint health-states utilities from single health-states utilities. Health economics 18(4), 403-19.

• Basu, A., W. Dale, A. Elstein, and D. Meltzer (2010), A time tradeoff method for eliciting partner’s quality of life due to patient’s health states in prostate cancer. Medical Decision Making 30(3), 355-65.

• Basu, A. and D. Meltzer (2005), Implications of spillover effects within the family for medical cost-effectiveness analysis. Journal of health economics 24(4), 751-73.

• Baumol, W. J. (1958), The cardinal utility which is ordinal. The Economic Journal 68(272), 665-672.

• Bell, D. E. and H. Raiffa (1982), Marginal value and intrinsic risk aversion. In H. Kunreuther (Ed.), Risk: A Seminar Series, Laxenburg, Austria, pp. 325-349. IIASA.

• Bravata, D. M., L. M. Nelson, A. M. Garber, and M. K. Goldstein (2010), Invariance and inconsistency in utility ratings. Medical Decision Making 25(2), 158-67.

• Buckingham, K. and N. Devlin (2006), A theoretical framework for TTO valuations of health. Health economics 15(10), 1149-54.

• Campian, R. S., C. Amariei, B. Crisan, G. Baciut, M. Baciut, O. Lucaciu, and A. Sava (2008), Calitatea vietii corelata cu sanatatea orala si cu cancerul oral si maxilofacial. Working Paper.

• Diener, E. and E. Suh (1997), Measuring quality of life: Economic, social, and subjective indicators. Social Indicators Research 40(1), 189-216.

• Dyer, J. S. and R. K. Sarin (1982), Relative risk aversion. Management Science 28, 875–886.

• Ellsberg, D. (1954), Classic and current notions of “measurable utility". The Economic Journal 64(255), 528-56.

• Farquhar, P. H. (1984), Utility assessment methods. Mangement Science 30(11), 1283–1300.

• Fishburn, P. C. (1989), Retrospective on the utility theory of von neumann and morgenstern. Journal of Risk and Uncertainty 2(2), 127-158.

• Giacaman, R., A. Mataria, V. Nguyen-Gillham, R. A. Safieh, A. Stefanini, and S. Chatterji (2007), Quality of life in the Palestinian context: an inquiry in war-like conditions. Health policy 81(1), 68-84.

• Hellinger, F. J. (1989), Expected utility theory and risky choices with health outcomes. Medical Care 27(3), 273-279.

• Karnofsky, D. A. and J. H. Burchenal (1949), The clinical evaluation of chemotherapeutic agents in cancer. In C. M. Maclead (Ed.), Evaluation of chemotherapeutic agents, New York, pp. 191-205. Columbia University Press.

• Larson, S. (2010), Regional well-being in tropical Queensland, Australia: developing a dissatisfaction index to inform government policy. Environment and Planning A 42(12), 2972-2989.

• Lenert, L. A. and R. M. Kaplan (2000), Validity and interpretation of preference-based measures of health-related quality of life. Medical care 38(9, Suppliment II), 138-150.

• Lenert, L. A., A. Sturley, and M. Rupnow (2003), Toward Improved Methods for Measurement of Utility: Automated Repair of Errors in Elicitations. Medical Decision Making 23(1), 67-75.

• Llewellyn-Thomas, H., H. Sutherland, R. Tibshirani, A. Ciampi, J. Till, and N. Boyd (1982), The Measurement of Patients’ Values in Medicine. Medical Decision Making 2(4), 449-462.

• Luce, R. D. and H. Raiffa (1957), Games and decisions: introduction and critical survey. New York: Wiley.

• Lupu, I. (2006), Calitatea vieţii în sănătate: Definitii şi instrumente de evaluare. Calitatea Vieţii 17(1-2), 73-91.

• Meltzer, D. (1997), Accounting for future costs in medical cost-effectiveness analysis. Journal of Health Economics 16(1), 33-64.

• Mulley, A. G. J. (1989), Assessing patients’ utilities: Can the ends justify the means? Medical Decision Making 27 (3, suppliment), 269-281.

• Revicki, D. A. and R. M. Kaplan (1993), Relationship between psychometric and utility-based approaches to the measurement of health-related quality of life. Quality of Life Research 2(6), 477-487.

• Rogerson, R. J. (1999), Quality of Life and City Competitiveness. Urban Studies 36(5), 969-985.

• Schwand, C., R. Vetschera, and L. Wakolbinger (2010), The influence of probabilities on the response mode bias in utility elicitation. Theory and Decision 69, 395-416. 10.1007/s11238-010-9193-8.

• Sinescu, I., M. A. Manu, M. Harza, B. Serbanescu, B. Stefan, V. Cerempei, C. Baston, D. Tacu, E. Kerezsy, C. Bucsa, I. Constantinescu, L. Domnisor, E. Burchiu, R. Manu, and O. Palea (2008), Studiul comparativ al calitatii vietii donatorilor de rinichi (tineri / varstnici si inruditi / neinruditi) folosind testul “sf-36 health survey”. Revista Română de Urologie (3), 1-9.

• Smidts, A. (1997), The relationship between risk attitude and strength of preferences: A test of intrinsic risk attitude. Management Science 43(3), 357-370.

• Stiglitz, J. E., A. Sen, and J.-P. Fitoussi (2009), Report by the Commission on the Measurement of Economic Performance and Social Progress.

• Tazebay, I., M. Somuncu, and N. Akpinar (2010), A quantitative assessment for quality of life : The case of metropolitan Ankara, Turkey. Journal of Agricultural Research 5(12), 1360-1372.

• Torrance, G. W. (1986), Measurement of health state utilities for economic appraisal. Journal of health economics 5(1), 1-30.

• Torrance, G. W. (1987), Utility approach to measuring health-related quality of life. Journal of chronic diseases 40(6), 593-603.

• Torrance, G. W. and D. H. Feeny (1989), Utilities and Quality-Adjusted Life Years. International Journal of Technology Assessment in Health Care 5(4), 559-575.

• Torrance, G. W., W. H. Thomas, and D. L. Sackett (1972), A utility maximization model for evaluation of health care programs. Health Services Research 7(2), 118-133.

• von Neumann, J. and O. Morgenstern (1944), Theory of Games and Economic Behavior. Princeton: Princeton University Press.




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