How to Measure Preferences Over Health Care Options?

Chicago, IL, USA – Allocation of resources across health care delivery modes is arguably as important as allocation of resources across diseases. For example, given a disease state such as advanced cancer, patients may experience significantly different quality of life (QOL) depending on whether the disease is treated at home, in a hospital, or in hospice. Yet, the science of understanding and comparing the benefits of health care delivery modes is much less developed than that of specific disease states. The potential benefits of different health care options need to be translated into comparable units such as quality-adjusted life years (QALY) across studies, so that researchers can better gauge the effectiveness of different approaches and provide valid scientific evidence to policy makers using this metric.

A team of researchers from the University of Chicago set out to lay the groundwork for developing a valid scientific methodology for quantifying preferences across health care options and health conditions, and to provide useful information to policy makers. The researchers used long-term care (LTC) delivery modes as an example and developed modified Time Trade-off (TTO) methods to quantify user’s preferences under different existing health care delivery modes, contingent on a specific health state.

Their findings show that the modified TTO technique seems to be a feasible method to quantify preferences over LTC delivery options. Moreover, preferences were clearly state-dependent: many participants expressed strong preferences for home care at lower levels of disability, but switched to preferring institutional care once the need for help became greater. These are different from what the policy makers have assumed.

Jing Guo, PhD, an economist at American Institutes for Research in Washington D.C., and the lead-author of the study said, “Our study extends TTO methods to health conditions that include health care delivery modes. It therefore serves as a proof of concept for using TTO methods to assess important policy questions about allocating LTC resources more efficiently. These methods may be applicable to a variety of health care alternatives where better evidence is needed to guide funding policy.” The full study, “Using Time Trade-Off Methods to Assess Preferences Over Health Care Delivery Options: A Feasibility Study,” is published in Value in Health.


Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research as well as policy papers to help health care leaders make evidence-based decisions. The journal is published bi-monthly and has over 8,000 subscribers (clinicians, decision makers, and researchers worldwide).

International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is a nonprofit, international, educational and scientific organization that strives to increase the efficiency, effectiveness, and fairness of health care resource use to improve health.

For more information: www.ispor.org

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