Title: Estimating the intangible victim costs of violent crime.
Authors: Dolan, Paul and Loomes, G. and Peasgood, Tessa and Tsuchiya, Aki
Publisher: British journal of criminology, 45 (6). pp. 958-976
Abstract: Current estimates of the intangible costs of violent crime, such as the pain, grief and suffering experienced by victims, are not very robust. This paper sets out the different methods that can be used to provide more defensible cost estimates, and that use data that are currently available. One of these methods involves estimating the number of quality-adjusted life years (QALYs) that victims of crime lose. The estimates suggest that rape results in the biggest losses, followed (in descending order) by: other wounding, common assault, serious wounding, murder, robbery and sexual assault.
Title: Health priorities and public preferences: the relative importance of past health experience and future health prospects
Authors: Dolan, Paul and Tsuchiya , Aki
Publisher: Journal of health economics, 24 (4). pp. 703-714
Abstract: We explore people’s choices where the preference for those with worse future health prospects and the preference for the young over the old conflict. The empirical study used scenarios with four attributes: past years, past health, future years without treatment, and future health without treatment. One hundred respondents ranked various patient groups described in these terms. The results suggest a strong effect of past years: younger groups (40-year-olds) were always chosen over older ones (60-year-olds). Past health was significant in one question but not the other and future health and years without treatment were both non-significant
Title: Developing a relativities approach to valuing the prevention of non-fatal work-related accidents and ill health
Authors: Karnon, Jonathan and Tsuchiya , Aki and Dolan, Paul
Publisher: Health economics, 14 (11). pp. 1103-1115
Abstract: The aim of the current explorative study is to define and test a process for the valuation of the benefits associated with the prevention of non-fatal work-related accidents and ill health. A relativities approach is adopted, and monetary values for the prevention of three forms of work-related illness are estimated. The approach involves describing relevant attributes of alternative events (accidents or occurrences of ill health), their causes, the characteristics of the relevant working population, and the number of events that are avoidable, and asking respondents to make pair wise choices between alternatives options for prevention. Indirect monetary valuations are obtained against a peg event for which a reliable valuation exists (road deaths). A series of discussion groups were held to identify relevant factors affecting potential valuations and to test the presentation of information. The predicted magnitude of responses for three-case study events (and road deaths) was estimated in a pilot study. These preliminary stages informed the final survey instrument that described five attributes in addition to a statement of the event and occupation, and the likely intervention effect, which was administered by post. Based on a small sample, the results show that virtually all respondents passed the inserted consistency test. The median respondent altered their choice according to the number of events avoided for all three comparisons, such that the estimated valuations appear sensible. Potential amendments are suggested, but the general relativities approach warrants further investigation for the valuation of non-fatal work-related accidents and ill health
Title: Procedural justice in public health care resource allocation
Authors: Dolan, Paul and Tsuchiya , Aki and Miguel, Luis and Edlin, Richard and Wailoo, Allan
Publisher: Applied health economics and health policy, 4 (2). pp. 119-127
Abstract: Introduction: The legal studies literature on procedural justice identifies six key characteristics of procedural justice: accuracy, consistency, impartiality, reversibility, transparency and voice. However, the relative importance of these in the context of public healthcare resource allocation is unclear, as is whether they are valuable instrumentally (because it contributes to better outcomes) or inherently (for its own sake). Methods: A survey of 80-odd members of the UK public determined the following: the ranking of all the six characteristics; the pairwise comparisons of the characteristics; and whether each characteristic was important for instrumental reasons, for intrinsic reasons or for both. Results: Respondents ranked the procedures in the order of accuracy, consistency, impartiality, reversibility and transparency. Procedural justice was valued for both instrumental and inherent reasons. Discussion/conclusion: A robust ranking of five of the six procedural characteristics was found. The ranking for voice was sensitive to the question format, which has methodological implications. Around a quarter to a third of respondents regarded a procedural characteristic to have entirely intrinsic value.
Title: Inconsistency and health state valuations
Authors: Dolan, Paul and Kind, Paul. In: Kind, Paul and Brooks, Richard and Rabin, Rosalind, (eds.)
Publisher: EQ-5D concepts and methods: a developmental history. Springer Netherlands, Rotterdam, The Netherlands, pp. 139-146
Abstract: The comparison of scaling methods used to value health states sometimes rests upon an analysis of aggregate scores. This analysis is usually undertaken once “inconsistent’ respondents have been excluded from the data. However, it is important to be able to judge the extent to which respondents as a whole are logically consistent when assigning values to health states. The degree of inconsistency will depend on how the health states are described, how the questionnaire is administered and who the respondents are. This paper analyses the inconsistency rates from two studies in which valuations for EuroQol health states were elicited using the visual analogue scale (VAS) method. The studies differed in design and incorporated several different variants of the standard EuroQol questionnaire, thus providing an opportunity to examine the relative importance of the different factors that were thought to affect inconsistency rates. Our general conclusions are that inconsistency rates are higher for interviewer-based than for postal surveys, possibly due to response bias, and that inconsistency rates are positively related to age and negatively related to educational attainment.
Title: QALY maximisation and people’s preferences: a methodological review of the literature
Authors: Dolan, Paul and Shaw, Rebecca and Tsuchiya , Aki and Williams, Alan
Publisher: Health economics, 14 (2). pp. 197-208
Abstract: In cost-utility analysis, the numbers of quality-adjusted life years (QALYs) gained are aggregated according to the sum-ranking (or QALY maximisation) rule. This requires that the social value from health improvements is a simple product of gains in quality of life, length of life and the number of persons treated. The results from a systematic review of the literature suggest that QALY maximisation is descriptively flawed. Rather than being linear in quality and length of life, it would seem that social value diminishes in marginal increments of both. And rather than being neutral to the characteristics of people other than their propensity to generate QALYs, the social value of a health improvement seems to be higher if the person has worse lifetime health prospects and higher if that person has dependents. In addition, there is a desire to reduce inequalities in health. However, there are some uncertainties surrounding the results, particularly in relation to what might be affecting the responses, and there is the need for more studies of the general public that attempt to highlight the relative importance of various key factors.
Title: Should patients have a greater role in valuing health states?
Authors: Brazier, J. and Akehurst, Ron and Brennan, Alan and Dolan, Paul and Claxton, Karl and McCabe, Chris and Sculpher, Mark and Tsuchyia, Aki
Publisher: Applied health economics and health policy, 4 (4). pp. 201-208
Abstract: Currently, health state values are usually obtained from members of the general public trying to imagine what the state would be like rather than by patients who are actually in the various states of health. Valuations of a health state by patients tend to vary from those of the general population, and this seems to be due to a range of factors including errors in the descriptive system, adaptation to the state and changes in internal standards. The question of whose values are used in cost-effectiveness analysis is ultimately a normative one, but the decision should be informed by evidence on the reasons for the differences. There is a case for obtaining better informed general population preferences by providing more information on what it is like for patients (including the process of adaptation).
Title: The QALY model and individual preferences for health states and health profiles over time: a systematic review of the literature
Authors: Tsuchiya, A. and Dolan, Paul
Publisher: Medical decision making, 25 (4). pp. 460-467, 2005
Abstract: The numbers of quality-adjusted life years (QALYs) gained are increasingly being used to represent the gains in individual utility from treatment. This requires that the value of a health improvement to an individual is a simple product of gains in quality of life and length of life. The article reports on a systematic review of the literature on 2 issues: whether the value of a state is affected by how long the state lasts, and by states that come before or after it. It was found that individual preferences over health are influenced by the duration of health states and their sequence. However, although there is much variation across individual respondents, the assumptions tend to hold much better when valuations are aggregated across respondents, which is encouraging for economic evaluations that rely on using average (mean or median) values.