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The Person-trade-off Approach to Valuing Health Care Programs

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  • Erik Nord

Abstract

The person-trade-off technique is a way of estimating the social values of different health care interventions. Basically it consists in asking people how many outcomes of one kind they consider equivalent in social value to X outcomes of another kind. The paper outlines a number of the author's previous studies using the technique. The studies suggest that while the technique is theoretically appealing for resource-allocation purposes, it is in practice quite demanding. It needs to be applied in fairly large groups of subjects to keep random measurement error at an acceptable level. Possible framing effects include the effects of argument presentation and the choice of start points in numerical exercises. To control for these effects, it seems important to take subjects through a multistep procedure, in which they are induced to carefully consider the various arguments that might be relevant in each exercise and to reconsider initial responses in the light of their implications. The investigator must also think through which decision context he or she wishes to study and make his or her choice of context very clear when reporting the results. In spite of these problems, the person-trade-off technique deserves greater attention in the field of cost-utility analysis. Key words: quality-adjusted life years; saved-young-life equivalent (SAVE); person trade-off; equivalence of numbers; health program evaluation. (Med Decis Making 1995;15:201-208)

Suggested Citation

  • Erik Nord, 1995. "The Person-trade-off Approach to Valuing Health Care Programs," Medical Decision Making, , vol. 15(3), pages 201-208, August.
    • Handle: RePEc:sae:medema:v:15:y:1995:i:3:p:201-208
    DOI: 10.1177/0272989X9501500302
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    References listed on IDEAS

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    1. Jan Abel Olsen, 1994. "Persons vs years: Two ways of eliciting implicit weights," Health Economics, John Wiley & Sons, Ltd., vol. 3(1), pages 39-46, January.
    2. Nord, Erik, 1993. "The trade-off between severity of illness and treatment effect in cost-value analysis of health care," Health Policy, Elsevier, vol. 24(3), pages 227-238, August.
    3. Kevin J. Boyle & Richard C. Bishop & Michael P. Welsh, 1985. "Starting Point Bias in Contingent Valuation Bidding Games," Land Economics, University of Wisconsin Press, vol. 62(2), pages 188-194.
    4. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
    5. Nord, Erik, 1989. "The significance of contextual factors in valuing health states," Health Policy, Elsevier, vol. 13(3), pages 189-198, December.
    6. Erik Nord, 1994. "The qaly—a measure of social value rather than individual utility?," Health Economics, John Wiley & Sons, Ltd., vol. 3(2), pages 89-93, March.
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