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Public Preferences for Prevention versus Cure: What if an Ounce of Prevention is Worth Only an Ounce of Cure?

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Listed:
  • Peter A. Ubel
  • Mark D. Spranca
  • Michael L. Dekay
  • John C. Hershey
  • David A. Asch

Abstract

Background. The belief that small preventive efforts bring large benefits may explain why many people say they value prevention above all other types of health care. However, it often takes a great deal of preventive medicine to prevent a bad outcome. This study explores whether people value prevention or cure more when each brings the same magnitude of benefit and examines whether preferences for prevention or cure vary according to the severity of the disability of the patients who can receive the preventive or curative intervention. Methods. 289 prospective jurors were presented with a policy dilemma involving how best to allocate funds to benefit people with varying levels of disability. Each project was said to influence the functional ability of 100 nursing home residents, either by improving their level of function or by preventing their level of function from declining. Results. When given a choice between preventive and curative interventions, more subjects preferred the preventive intervention (37% vs 21%, p = 0.002). However, when the strength of people's preferences was taken into account, the preference for preventive interventions was not statistically significant (p = 0.135). With both preventive and curative interventions, the subjects preferred helping patients with more severe disabilities (p

Suggested Citation

  • Peter A. Ubel & Mark D. Spranca & Michael L. Dekay & John C. Hershey & David A. Asch, 1998. "Public Preferences for Prevention versus Cure: What if an Ounce of Prevention is Worth Only an Ounce of Cure?," Medical Decision Making, , vol. 18(2), pages 141-148.
    • Handle: RePEc:sae:medema:v:18:y:1998:i:2:p:141-148
    DOI: 10.1177/0272989X9801800202
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    Cited by:

    1. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208, February.
    2. Abellán Perpiñán, José Mª & Sánchez Martínez,Fernando I. & Martínez Pérez, Jorge E., 2007. "La medición del bienestar social relacionado con la salud/The Measurement of the Health Related Social Welfare," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 25, pages 927-950, Diciembre.
    3. Phaedra S. Corso & Stephen B. Thacker & Jeffrey P. Koplan, 2002. "The Value of Prevention: Experiences of a Public Health Agency," Medical Decision Making, , vol. 22(1_suppl), pages 11-16, September.
    4. Jeff Richardson & John McKie & Stuart Peacock & Angelo Iezzi, 2011. "Severity as an independent determinant of the social value of a health service," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 163-174, April.
    5. Pinkerton, Steven D. & Johnson-Masotti, Ana P. & Derse, Arthur & Layde, Peter M., 2002. "Ethical issues in cost-effectiveness analysis," Evaluation and Program Planning, Elsevier, vol. 25(1), pages 71-83, February.
    6. Phaedra S. Corso & James K. Hammitt & John D. Graham & Richard C. Dicker & Sue J. Goldie, 2002. "Assessing Preferences for Prevention versus Treatment Using Willingness to Pay," Medical Decision Making, , vol. 22(1_suppl), pages 92-101, September.
    7. Richardson, Jeff & McKie, John, 2007. "Economic evaluation of services for a National Health Scheme: The case for a fairness-based framework," Journal of Health Economics, Elsevier, vol. 26(4), pages 785-799, July.
    8. Odejar, Maria & Baker, Rachel & Ryan, Mandy & Donalson, Cam & Bateman, Ian J. & Jones-Lee, M & Lancsar, Emily & Mason, Helen & Pinto Paredes, JL & Robinson, A & Shackley, P & Smith, R & Sugdem, R & Wi, 2010. "Weighting and valuing quality-adjusted life-years using stated preference methods: preliminary results from the Social Value of a QALY Project," MPRA Paper 108869, University Library of Munich, Germany.
    9. Ikenwilo, Divine, 2013. "A difference-in-differences analysis of the effect of free dental check-ups in Scotland," Social Science & Medicine, Elsevier, vol. 83(C), pages 10-18.
    10. Coast, Joanna, 2009. "Maximisation in extra-welfarism: A critique of the current position in health economics," Social Science & Medicine, Elsevier, vol. 69(5), pages 786-792, September.

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