Prosser Lisa A, Wittenberg Eve
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA.
Med Decis Making. 2007 May-Jun;27(3):281-7. doi: 10.1177/0272989X07300602.
To evaluate differences in risk attitude across the domains of health and money for 2 types of respondents, patients and community members.
Two groups of respondents, patients with multiple sclerosis (n = 56) and members of the general community (n = 57), completed a survey that collected information on risk attitudes and socioeconomic and clinical variables (e.g., disability level). Risk attitude was measured using 2 standard-gamble questions on money and 1 standard-gamble question on health outcomes. Multivariate regression was used to evaluate the relationship between risk attitude and respondent type (patient v. community), adjusting for covariates that could affect risk attitude.
The median certainty equivalents for money gambles were significantly different from and less than the expected value of the gamble for both types of respondents. Median certainty equivalents for the health gamble were not significantly different from the expected value for either group of respondents. For all 3 gambles, there was no difference in median certainty equivalents between the 2 types of respondents in both unadjusted and adjusted analyses.
Risk attitude varied across domains but not by respondent type. Patients and community members were predominantly risk neutral with respect to health outcomes and risk averse with respect to money. Research on risk preferences on money outcomes may not be an appropriate proxy for risk preferences regarding health outcomes. Risk preferences may depend more on characteristics of the choice than on respondent type.
评估患者和社区成员这两类受访者在健康和金钱领域的风险态度差异。
两组受访者,即多发性硬化症患者(n = 56)和普通社区成员(n = 57),完成了一项调查,该调查收集了有关风险态度以及社会经济和临床变量(如残疾程度)的信息。风险态度通过两个关于金钱的标准博弈问题和一个关于健康结果的标准博弈问题来衡量。使用多元回归来评估风险态度与受访者类型(患者与社区成员)之间的关系,并对可能影响风险态度的协变量进行调整。
对于这两类受访者,金钱博弈的中位数确定性等价物均与博弈的预期价值显著不同且低于预期价值。健康博弈的中位数确定性等价物与两组受访者的预期价值均无显著差异。在未调整和调整分析中,对于所有3种博弈,两类受访者的中位数确定性等价物均无差异。
风险态度因领域而异,但不因受访者类型而异。患者和社区成员在健康结果方面主要是风险中性的,而在金钱方面是风险厌恶的。关于金钱结果的风险偏好研究可能不是健康结果风险偏好的合适替代指标。风险偏好可能更多地取决于选择的特征而非受访者类型。