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Does the use of the proportional shortfall help align the prioritisation of health services with public preferences?

Jeff Richardson (jeffrey.richardson@monash.edu), Angelo Iezzi, Aimee Maxwell and Gang Chen (chengang1029@gmail.com)
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Jeff Richardson: Monash University
Angelo Iezzi: Monash University
Aimee Maxwell: Monash University

The European Journal of Health Economics, 2018, vol. 19, issue 6, No 4, 797-806

Abstract: Abstract It has been proposed that equity may be included in the economic evaluation of health services using the ‘proportional shortfall’ (PS)—the proportion of a person’s QALY expectation that they would lose because of an illness. The present paper reports the results of a population survey designed to test whether PS helped to explain people’s preferences for health services and whether it did this better than the absolute shortfall or the equity related variables that PS seeks to replace. Survey respondents were asked to allocate 100 votes between 13 scenarios and a standard scenario. Variation in the allocation of votes was explained by health gain and different combinations of the equity variables. Differences in votes for the comparisons were significantly related to differences in PS but the relationship was weaker than between votes and the age related variables. Cases were identified where PS suggested a priority ordering of services which was strongly rejected by respondents. It is concluded that the use of PS is unlikely to improve the alignment of priorities with public preferences.

Keywords: Proportional shortfall; Fair innings; Severity; Equity-efficiency; Economic evaluation; Cost utility analysis (search for similar items in EconPapers)
JEL-codes: I18 (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10198-017-0923-5

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