A comparison of Hong Kong and United Kingdom SF-6D health states valuations using a nonparametric Bayesian method

There is interest in the extent to which valuations of health may differ between different countries and cultures, but few studies have compared preference values of health states obtained in different countries. The present study applies a nonparametric model to estimate and compare two HK and UK standard gamble values for six-dimensional health state short form (derived from short-form 36 health survey) (SF-6D) health states using Bayesian methods.

The data set is the HK and UK SF-6D valuation studies in which two samples of 197 and 249 states defined by the SF-6D were valued by representative samples of the HK and UK general populations, respectively, both using the standard gamble technique. We estimated a function applicable across both countries that explicitly accounts for the differences between them, and is estimated using the data from both countries.

The results suggest that differences in SF-6D health state valuations between the UK and HK general populations are potentially important. In particular, the valuations of Hong Kong were meaningfully higher than those of the United Kingdom for most of the selected SF-6D health states. The magnitude of these country-specific differences in health state valuation depended, however, in a complex way on the levels of individual dimensions.

The new Bayesian nonparametric method is a powerful approach for analyzing data from multiple nationalities or ethnic groups to understand the differences between them and potentially to estimate the underlying utility functions more efficiently.