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Cultural Values: Can They Explain Differences in Health Utilities between Countries?

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  • Bram Roudijk

    (Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Gelderland, the Netherlands)

  • A. Rogier T. Donders

    (Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Gelderland, the Netherlands)

  • Peep F. M. Stalmeier

    (Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Gelderland, the Netherlands)

Abstract

Introduction. Health utilities are widely used in health care. The distributions of utilities differ between countries; some countries more often report worse than dead health states, while mild states are valued more or less the same. We hypothesize that cultural values explain these country-related utility differences. Research Question. What is the effect of sociodemographic background, methodological factors, and cultural values on differences in health utilities? Methods and Analyses. Time tradeoff data from 28 EQ-5D valuation studies were analyzed, together with their sociodemographic variables. The dependent variable was Δ u , the utility difference between mild and severe states. Country-specific cultural variables were taken from the World Values Survey. Multilevel models were used to analyze the effect of sociodemographic background, methodology (3L v. 5L), and cultural values on Δ u . Intraclass correlation (ICC) for country variation was used to assess the impact of the predicting variables on the variation between countries. Results. Substantial variation in Δ u was found between countries. Adding cultural values did not reduce ICCs for country variation. Sociodemographic background variables were only weakly associated with Δ u and did not affect the ICC. Δ u was 0.118 smaller for EQ-5D-5L studies. Discussion. Δ u varies between countries. These differences were not explained by national cultural values. In conclusion, despite correction for various variables, utility differences between countries remain substantial and unexplained. This justifies the use of country-specific value sets for instruments such as the EQ-5D.

Suggested Citation

  • Bram Roudijk & A. Rogier T. Donders & Peep F. M. Stalmeier, 2019. "Cultural Values: Can They Explain Differences in Health Utilities between Countries?," Medical Decision Making, , vol. 39(5), pages 605-616, July.
    • Handle: RePEc:sae:medema:v:39:y:2019:i:5:p:605-616
    DOI: 10.1177/0272989X19841587
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    1. Agata Łaszewska & Ayesha Sajjad & Jan Busschbach & Judit Simon & Leona Hakkaart-van Roijen, 2022. "Conceptual Framework for Optimised Proxy Value Set Selection Through Supra-National Value Set Development for the EQ-5D Instruments," PharmacoEconomics, Springer, vol. 40(12), pages 1221-1234, December.
    2. Donna Rowen & Clara Mukuria & Emily McDool, 2022. "A Systematic Review of the Methodologies and Modelling Approaches Used to Generate International EQ-5D-5L Value Sets," PharmacoEconomics, Springer, vol. 40(9), pages 863-882, September.
    3. Stefan A. Lipman & Brigitte A. B. Essers & Aureliano P. Finch & Ayesha Sajjad & Peep F. M. Stalmeier & Bram Roudijk, 2022. "In a Child’s Shoes: Composite Time Trade-Off Valuations for EQ-5D-Y-3L with Different Proxy Perspectives," PharmacoEconomics, Springer, vol. 40(2), pages 181-192, December.
    4. Bram Roudijk & Ayesha Sajjad & Brigitte Essers & Stefan Lipman & Peep Stalmeier & Aureliano Paolo Finch, 2022. "A Value Set for the EQ-5D-Y-3L in the Netherlands," PharmacoEconomics, Springer, vol. 40(2), pages 193-203, December.
    5. Sahar Al Shabasy & Maggie Abbassi & Aureliano Finch & Bram Roudijk & Darrin Baines & Samar Farid, 2022. "The EQ-5D-5L Valuation Study in Egypt," PharmacoEconomics, Springer, vol. 40(4), pages 433-447, April.

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