一种用于估计GRACE公用事业和支付纠正意愿的实用方法.
Anirban Basu1, Darius Lakdawalla1
1The CHOICE Institute University of Washington, National Bureau of Economic Research, Seattle, Washington, USA; Schaeffer Center for Health Policy and Economics, University of Southern California, National Bureau of Economic Research, Los Angeles, California, USA.
概括
本研究引入了一种线性映射,用于从时间权衡 (TTO) 措施中估计通用风险调整成本效益 (GRACE) 公用事业. 这种方法提高了医疗公用事业的准确性,特别是在严重的健康状况下,不需要新的数据收集.
科学领域:
- 卫生经济学 卫生经济学
- 决策分析 决策分析
- 生物统计学 生物统计学
背景情况:
- 标准的健康实用措施往往忽视了风险偏好.
- 一般化风险调整成本效益 (GRACE) 包含风险偏好,但通常需要视觉模拟量表 (VAS) 健康状态公用事业.
- 汽车安全系统的指标可能并不总是可供分析师使用.
研究的目的:
- 开发一种经验方法,从随时可用的时间权衡 (TTO) 实用程序中推导出GRACE实用程序.
- 为了使GRACE在成本效益分析中使用,当只有TTO数据存在时.
- 为调整支付意愿值基于TTO衍生的GRACE值提供一个实际的解决方案.
主要方法:
- 使用了包含VAS和TTO健康状况指标的全国代表性患者级数据.
- 估计了一种线性回归模型,将TTO公用事业与VAS公用事业映射起来.
- 应用已发布的GRACE公用事业估计和衍生出的TTO-to-VAS映射来创建TTO-to-GRACE公用事业转换.
主要成果:
- 一个线性模型证明了TTO和VAS健康状态公用事业之间最有效的映射.
- 对于中度健康状况,TTO公用事业与VAS公用事业非常接近,但对不那么中度的健康状况显示出更大的错误.
- 对于严重的健康状况,TTO公用事业系统地低估了VAS健康公用事业 (TTO < 0.4).
结论:
- 通过简单的线性映射,可以使用传统的TTO测量来估计GRACE公用事业.
- 仅依赖TTO公用事业的现有研究可能低估了重病人群健康改善的GRACE价值.
- 这种方法提供了一种计算GRACE和调整支付意愿值的方法,而无需生成新的患者数据.
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