Happich Michael, von Lengerke Thomas
GSF-National Research Center for Environment and Health, Institute of Health Economics and Health Care Management, P.O. Box 1129, 85758 Neuherberg, Germany.
Hear Res. 2005 Sep;207(1-2):50-8. doi: 10.1016/j.heares.2005.04.002.
In recent years, prioritisation in health care has gained increasing attention. However, rankings of interventions might depend on whom valuations of health states are elicited from. This paper's objective is to compare tinnitus valuations by patients and the general public.
Groups of 210 patients and 210 adults not (currently) affected were interviewed to elicit valuations using visual analogue scale (VAS), time trade-off (TTO) and standard gamble (SG). MANOVA is used to test for group differences, controlling for sex and age.
For all elicitation methods, valuations significantly differ in that patients report higher values than the general public respondents. Most notably, on the visual analogue scale which varies between 0 ('worst imaginable health') and 1 ('best imaginable health'), patients elicit a mean score of 0.54, and the general public 0.34 (those with former tinnitus experience) and 0.35 (without experience), respectively (F(2,377)=55.67, p<0.001). That is, patients valuate tinnitus as less severe than unaffected people.
As for other health states, tinnitus valuations differ depending on whether values of patients or the general public are elicited. These differences should be taken into account in health care evaluation and planning.
近年来，医疗保健中的优先排序受到越来越多的关注。然而，干预措施的排名可能取决于从谁那里获取健康状态的估值。本文的目的是比较患者和普通公众对耳鸣的估值。
对210名患者组和210名未（目前）受影响的成年人进行访谈，使用视觉模拟量表（VAS）、时间权衡法（TTO）和标准博弈法（SG）来获取估值。使用多变量方差分析来检验组间差异，并控制性别和年龄因素。
对于所有的估值方法，患者报告的估值显著高于普通公众受访者，二者存在显著差异。最值得注意的是，在0（“可想象到的最差健康状况”）到1（“可想象到的最佳健康状况”）之间变化的视觉模拟量表上，患者得出的平均分数为0.54，而普通公众分别为0.34（有耳鸣既往经历者）和0.35（无耳鸣既往经历者）（F(2,377)=55.67，p<0.001）。也就是说，患者认为耳鸣的严重程度低于未受影响的人。
与其他健康状况一样，耳鸣的估值因获取的是患者还是普通公众的价值观而有所不同。在医疗保健评估和规划中应考虑这些差异。
