对于老年人来说,在治疗决策中最重要的是:一个离散选择实验
Vera C Hanewinkel1, Hanneke van der Wal-Huisman2, Suzanne Festen3
1Department of Policy, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
PloS one
|November 3, 2025
概括
老年人优先考虑独立,避免疼痛/记忆问题,而不是面对严重疾病时延长预期寿命. 一个较小的群体更重视延长寿命,强调医疗决策中患者的不同偏好.
科学领域:
- 老年学是一门学科.
- 医疗决策的制定 医疗决策的制定
- 卫生经济学 卫生经济学
背景情况:
- 传统的医学决策往往侧重于疾病特异性结果,如生存率.
- 对于老年人来说,保持独立和生活质量比延长寿命同等或更重要.
- 了解社区老年人的优先事项对于优化治疗决策和医疗保健政策至关重要.
研究的目的:
- 确定50岁及以上的成年人在选择危及生命的疾病的假设治疗方法时的结果偏好.
- 探索预期寿命,独立,疼痛,记忆和社会成本等因素如何影响这些选择.
主要方法:
- 对333名50岁及以上的参与者进行了一项离散选择实验 (DCE).
- 参与者根据五个属性评估假设的治疗选择:预期寿命,独立性,疼痛,记忆问题和社会成本.
- 使用条件逻辑和隐性类分析来确定属性实用性和识别偏好子组.
主要成果:
- 大多数参与者优先考虑保持独立,其次是预期寿命和避免严重损伤.
- 预期寿命仅在延长至少两年时才被评估;社会成本也影响了选择.
- 隐性阶级分析揭示了两个子组:一个优先考虑预期寿命,另一个强调独立性和较低的社会成本.
结论:
- 大多数年龄在50岁以上的人面临危及生命的疾病优先考虑独立,并最大限度地减少严重的疼痛/记忆问题,而不是最大限度地延长预期寿命.
- 一个不同的子组优先考虑预期寿命,表明患者的偏好各不相同.
- 这些不同的偏好,包括社会成本,必须为个人治疗决策,临床指南和医疗保健政策提供信息.
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