Abstract:
OBJECTIVE:Cost-utility analysis is gaining importance as a tool for setting priorities in health care. The approach requires quality-of-life weights on a scale from 0.00 (corresponding to death) to 1.00 (corresponding to perfect health). Different methods and perspectives of the evaluators tend to give different results. Time trade-off (TTO) is the most commonly used method to elicit quality-of-life weights for quality-adjusted life-years (QALYs). How reliable are the results of this method, when limited to one specific perspective, as input for cost-utility analysis? METHOD:Systematic literature review of empirical studies in which the TTO is elicited by the respondent on their own behalf. RESULTS:In 56 papers, quality-of-life weights for 102 diagnostic groups were given. Ranking of the diagnostic groups according to their quality-of-life weights had no apparent relation to severity. One specific diagnostic group was assigned quality-of-life weights ranging from 0.39 to 0.84. Altogether, 57% of respondents did not trade any life-time at all in exchange for health improvements. The distributions studied were skewed towards 1.00 and were bimodal without a central tendency. The correlation between the TTO and related methods was generally weak. Possible explanations for the poor empirical properties of the TTO are inappropriate use of the method, lack of representative samples, or that the TTO does not measure what it claims to measure. CONCLUSION:In the light of these findings, the TTO elicited from the patient perspective, as currently practised, should not be used as an input for QALYs or for comparisons of diagnostic groups.
journal_name
J Health Serv Res Policyjournal_title
Journal of health services research & policyauthors
Arnesen T,Trommald Mdoi
10.1258/135581904322716111subject
Has Abstractpub_date
2004-01-01 00:00:00pages
43-50issue
1eissn
1355-8196issn
1758-1060journal_volume
9pub_type
杂志文章,评审abstract:OBJECTIVES:To examine the extent to which proximity to the income threshold for free GP care results in significant differences in GP visiting. Approximately 30% of the Irish population receives free GP care (medical card patients), while the remaining 70% pays in full (private patients). Medical card eligibility exert...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008048
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Automated pharmacy data have been used to develop a measure of chronic disease status in the general population. The objectives of this project were to refine and apply a model of chronic disease identification using Italian automated pharmacy data; to describe how this model may identify patt...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581905774414259
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVES:To assess whether it is feasible to elicit patients' preferences for treatments and then to proceed with randomisation which may allocate those with preferences to their less preferred treatment; and to describe which prognostic variables were associated with such preferences within the context of a randomis...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969600100403
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVES:To examine the influence of the English National Health Service (NHS) South and West (S&W) region Development and Evaluation Committee (DEC) technology appraisal reports on purchasing and clinical decisions in the S&W and elsewhere in the NHS, and to estimate the cost of the DEC process. METHODS:Two postal ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960300800106
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Improvements in health service provision need not be costly and indeed may save money. Administration of radio iodine ((131)I) to patients with thyrotoxicosis in the UK is often delayed because few endocrinologists have appropriate Administration of Radioactive Substances Advisory Committee (ARSAC) certifica...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907782101534
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:the nature of care delivered in emergency departments has changed due to increased demand. In response, one relatively new change is the introduction of a physiotherapy service. There have been anecdotal reports that this may reduce patient waiting times and lead to more effective use of other health care sta...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/jhsrp.2010.009129
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness and cost of obtaining consent for review of medical records within the passively observed non-intervention arm of a cluster randomized controlled trial, 'Comparison Arm for ProtecT'. METHODS:Two hundred and thirty men, who had been notified to the trial by cancer registries as h...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008085
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To evaluate how UK maternity unit protocols conformed to national recommendations for preventing early-onset neonatal Group B Streptococcal (GBS) disease. METHODS:In December 2005, all UK obstetric maternity units were contacted and asked to provide a copy of their protocol on preventing GBS disease. Informa...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2007.007144
更新日期:2008-04-01 00:00:00
abstract::The study, first published in 2003, looks at the root causes of adverse events and near misses in obstetrics at seven hospital maternity units by interviewing 93 members of staff, identifying the areas of mismanagement in each case and thematically analysing them. ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.09s106
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Physician gender may be a source of differences in communication between physicians and their patients, which may in turn contribute to patient satisfaction and other outcomes. Our aim was to review systematically research on gender differences in the length, style and content of communication with patients. ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,meta分析,评审
doi:10.1177/1355819613486465
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:The National Service Framework (NSF) for Coronary Heart Disease--published by the English Department of Health in 2000--sets out how those within the health service should seek to prevent and treat coronary heart disease and care for people with the disease. Its prescriptions are partly based on what is know...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581906776318956
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To explore the tensions across the primary-secondary interface when referral from primary care is to a team and to inform service developments in other specialties. METHODS:A nested qualitative study within a randomized controlled trial of primary care and Community Mental Health Teams (CMHTs) in Croydon and...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1258/jhsrp.2007.006053
更新日期:2008-01-01 00:00:00
abstract::The incorporation of genetics into health services research has largely floundered, despite the rapidly accelerating availability of, and access to, such data. This is expected given the ethical questions involved. However, using these new resources robustly to examine population choices when it comes to health insure...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819616664374
更新日期:2017-01-01 00:00:00
abstract::This paper deals with three concerns about the evaluative framework that is currently dominant within health economics. These concerns are: that the evaluative framework is concerned entirely with health; that the evaluative framework has an individualistic focus on patients alone; and that the methods used to estimat...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008024
更新日期:2008-10-01 00:00:00
abstract::Diagnosis-related groups are widespread across Europe and they are meant to be a central instrument to improve the activity and efficiency of hospitals. However, there are many examples of diagnosis-related groups having adverse effects which are difficult to control and which endanger the goals of health care systems...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819615586444
更新日期:2016-01-01 00:00:00
abstract:AIMS:To evaluate the extent to which structural variation between English general practices is accounted for at higher organisational levels in the National Health Service (NHS). METHODS:We analysed data for 11 structural characteristics of all general practices in England. These included characteristics of general pr...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581903321466058
更新日期:2003-04-01 00:00:00
abstract::We review the foundations of resource allocation rules based on cost-effectiveness information. Comprehensive approaches, where a total budget is allocated in one go, require estimation of the costs and effects of all available health care programmes, which is unlikely to be practical. A common alternative is to asses...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/1355819042250177
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVES:To determine the extent to which reports of Cochrane reviews recommend the need for further research and, if so, the extent to which they make suggestions regarding that research. METHODS:We examined all 2535 reviews in Issue 4, 2005 of The Cochrane Library. Each review was categorized on the basis of wheth...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907780279648
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:The effects of demographic, locational and socio-economic disadvantage, and the influence of private health care on five-year mortality rates in patients with lung cancer or after breast cancer surgery in Western Australia were examined. METHODS:The Western Australian Record Linkage Project was used to extra...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/1355819042248116
更新日期:2004-10-01 00:00:00
abstract::Policy-makers and managers have always used a wide range of sources of evidence in making decisions about policy and the organization of services. However, they are under increasing pressure to adopt a more systematic approach to the utilization of the complex evidence base. Decision-makers must address complicated qu...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/1355819054308576
更新日期:2005-07-01 00:00:00
abstract::Medicaid waivers have been a principal tool of innovation in health policy in the US since at least the mid 1970s. As Republicans seek to give the states more flexibility in their implementation and management of both Medicaid and the Affordable Care Act or its replacement, waiver authority is likely to be one of the ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819617702175
更新日期:2017-10-01 00:00:00
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journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.009121
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To review the impact of payment systems on the behaviour of primary care physicians. METHODS:All randomised trials, controlled before and after studies, and interrupted time series studies that compared capitation, salary, fee-for-service or target payments (mixed or separately) that were identified by compu...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/1355819011927198
更新日期:2001-01-01 00:00:00
abstract::Understanding the environmental and behavioural predictors of wellbeing is a key driver of health and social care research. Research set in the social world examines the relationships between behavioural, cognitive, emotional and environmental factors, linking these to disease or social ills with the aim of providing ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.010016
更新日期:2011-07-01 00:00:00
abstract::Patients are increasingly using the internet to access information on health care and services, as well as writing reviews of their own experiences. With patient choice increasing in many health systems, payers, purchasers and providers are attempting to take control of this trend by designing and managing their own p...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.010010
更新日期:2011-04-01 00:00:00
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journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.009025
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:To conduct an economic evaluation comparing a traditional antenatal visiting schedule (traditional care) with a reduced schedule of visits (new style care) for women at low risk of complications. METHODS:Economic evaluation using the results of a randomised controlled trial, the Antenatal Care Project. This...
journal_title:Journal of health services research & policy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/135581960000500203
更新日期:2000-04-01 00:00:00
abstract::The National Health Service (NHS) in England is not only a commissioner and provider of health care to the sick, but also offers certainty and peace of mind to all citizens--even those who do not use the health service in any year. However, due to the recent dominance of cost-effectiveness and cost-utility analysis as...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.009024
更新日期:2010-07-01 00:00:00
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journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819617725546
更新日期:2018-01-01 00:00:00
abstract::It is important to include non English speakers in health services research to ensure not only the generalisability of findings but also to address health inequalities and promote social justice. One approach is to use interpreters but there is little guidance for working with an interpreter in interviews. Involving a...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/JHSRP.2012.012003
更新日期:2012-07-01 00:00:00