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Whose preferences count?

P Dolan1

  • 1Sheffield Health Economics Group and Department of Economics, University of Sheffield, England, UK. P.Dolan@sheffield.ac.uk

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|October 16, 1999
PubMed
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Determining whose preferences matter for health-related quality of life (HRQoL) is key for resource allocation. This paper argues against a false dichotomy, proposing a new framework to consider adaptation to illness when valuing health states.

Area of Science:

  • Health Economics
  • Health Services Research
  • Quality of Life Assessment

Background:

  • Resource allocation decisions hinge on improving patients' health-related quality of life (HRQoL).
  • A significant debate exists regarding whether patient or general public preferences are most appropriate for measuring and valuing HRQoL.

Purpose of the Study:

  • To challenge the existing dichotomy in HRQoL preference debates.
  • To introduce a conceptual framework for a more productive discussion on whose preferences should be prioritized.
  • To address the critical issue of accounting for adaptation to poor health states in value assessments.

Main Methods:

  • Conceptual analysis and framework development.
  • Critique of existing dichotomous approaches to preference valuation.

Related Experiment Videos

  • Exploration of the implications of patient adaptation to health states.

    • Main Results:

    • The patient versus general public dichotomy is a false dichotomy that hinders empirical understanding.
    • Existing debates often fail to incorporate the crucial factor of adaptation to illness.
    • A new conceptual framework is proposed to guide preference valuation discussions.

    Conclusions:

    • Rethinking the basis of preference valuation in HRQoL is essential for effective healthcare resource allocation.
    • The framework facilitates a more nuanced understanding by considering adaptation.
    • This approach offers a more fruitful path for addressing the complexities of whose preferences count.