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Does the use of the proportional shortfall help align the prioritisation of health services with public preferences?

Author

Listed:
  • Jeff Richardson

    (Monash University)

  • Angelo Iezzi

    (Monash University)

  • Aimee Maxwell

    (Monash University)

  • Gang Chen

    (Monash University)

Abstract

It has been proposed that equity may be included in the economic evaluation of health services using the ‘proportional shortfall’ (PS)—the proportion of a person’s QALY expectation that they would lose because of an illness. The present paper reports the results of a population survey designed to test whether PS helped to explain people’s preferences for health services and whether it did this better than the absolute shortfall or the equity related variables that PS seeks to replace. Survey respondents were asked to allocate 100 votes between 13 scenarios and a standard scenario. Variation in the allocation of votes was explained by health gain and different combinations of the equity variables. Differences in votes for the comparisons were significantly related to differences in PS but the relationship was weaker than between votes and the age related variables. Cases were identified where PS suggested a priority ordering of services which was strongly rejected by respondents. It is concluded that the use of PS is unlikely to improve the alignment of priorities with public preferences.

Suggested Citation

  • Jeff Richardson & Angelo Iezzi & Aimee Maxwell & Gang Chen, 2018. "Does the use of the proportional shortfall help align the prioritisation of health services with public preferences?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 797-806, July.
    • Handle: RePEc:spr:eujhec:v:19:y:2018:i:6:d:10.1007_s10198-017-0923-5
    DOI: 10.1007/s10198-017-0923-5
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    References listed on IDEAS

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    1. Richard Carson & Jordan Louviere, 2011. "A Common Nomenclature for Stated Preference Elicitation Approaches," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 49(4), pages 539-559, August.
    2. Stolk, Elly A. & Pickee, Stefan J. & Ament, Andre H.J.A. & Busschbach, Jan J.V., 2005. "Equity in health care prioritisation: An empirical inquiry into social value," Health Policy, Elsevier, vol. 74(3), pages 343-355, November.
    3. E. Wetering & E. Stolk & N. Exel & W. Brouwer, 2013. "Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 107-115, February.
    4. Chris Skedgel & Dean Regier, 2015. "Constant-Sum Paired Comparisons for Eliciting Stated Preferences: A Tutorial," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(2), pages 155-163, April.
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    Cited by:

    1. Collewet, Marion & Koster, Paul, 2023. "Preference estimation from point allocation experiments," Journal of choice modelling, Elsevier, vol. 48(C).

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    More about this item

    Keywords

    Proportional shortfall; Fair innings; Severity; Equity-efficiency; Economic evaluation; Cost utility analysis;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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