A comparison of individual and social time trade-off values for health states in the general population.
This study aimed to compare directly elicited individual time trade-off (TTO) values in a general population sample with the social values derived using the UK EQ-5D index tariff. In the Stockholm County 1998 postal Public Health Survey (n=4950, 20-88 years), the EQ-5D self-classifier, a TTO and a rating scale (RS) question were included (n=2549 for all three questions). The mean TTO (EQ-5D) value was 0.943 (0.890) in the youngest age-group and 0.699 (0.733) in the oldest age-group. The difference between TTO and EQ-5D values was greater in more severe health status groups was. The same equation as for the UK EQ-5D index tariff was estimated for TTO and RS and resulted in significant and consistent coefficients for nearly all dimensions. The coefficients for moderate problems were closer to the EQ-5D index tariff than the coefficients for severe problems. Age was also significant after controlling for the EQ-5D dimensions (p<0.05). The results suggest that individual and social TTO values differ systematically and that the difference is greater the more severe the health status is. The social EQ-5D index tariff may also underestimate the severity in health status at older ages; age appears to correlate with additional health problems not captured by the EQ-5D classification.
Burström
Kristina
K
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Norrbacka, SE-171 76 Stockholm, Sweden. kristina.burstrom@sll.se
Johannesson
Magnus
M
Diderichsen
Finn
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D012945:Social Values; D011795:Surveys and Questionnaires; D013548:Sweden