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测试健康偏好的非单调性
Jose-Maria Abellan-Perpiñan1, Jorge-Eduardo Martinez-Perez1, Jose-Luis Pinto-Prades2
1Applied Economics Department, Faculty of Economics and Business, University of Murcia, Murcia, Spain.
概括
许多人表现出对健康持续时间的非单调偏好,在某一点之后更喜欢更短的持续时间. 这挑战了标准的健康经济模型,并突出了最大耐受时间现象.
科学领域:
- 卫生经济学 卫生经济学
- 决策科学 决策科学 决策科学
- 心理测量 心理测量 心理测量
背景情况:
- 以前的研究表明,个人可能更喜欢较短时间的健康状况不佳,直到最大耐受时间 (MET).
- 了解对健康持续时间的偏好对于卫生政策和经济建模至关重要,特别是对质量调整寿命年 (QALYs).
研究的目的:
- 在各种健康状况中实证测试生命周期偏好的单调性.
- 调查最大耐受时间 (MET) 偏好和偏好逆转的流行情况.
主要方法:
- 使用两个顺序任务:直接选择和健康事件的排名,将EQ-5D-3L状态和持续时间结合起来.
- 招募了90名参与者参加实验性会议,以引起和分析偏好模式.
- 量化单调性违反和选择和排名任务之间的偏好反转.
主要成果:
- 观察到大量的非单调偏好率,从49% (选择) 到71% (排名) 在受试者中.
- 每个健康状况的平均非单调性率为22% (选择) 和34% (排名).
- 发现了偏好逆转的证据 (1.5%-33%) 和稀有的过渡性违规.
结论:
- 非单调的偏好,特别是MET现象,在中等范围的健康状况中普遍存在.
- 观察到的偏好逆转表明,对于不同任务使用类似的响应尺度存在潜在的限制.
- 这些发现挑战了乘法QALY模型的有效性,并强调了需要更细致的偏好诱导的需要.
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