Welch H G
Dartmouth Medical School, Hanover, NH.
Gerontologist. 1991 Jun;31(3):332-6. doi: 10.1093/geront/31.3.332.
This paper considers the role patient age plays in the type of outcome analysis most germane for policymakers: cost-effectiveness analysis. The magnitude of age bias is quantified and means to modify it are described. In particular, present value analysis (discounting) is demonstrated to markedly attenuate the effect of patient age on cost-effectiveness analysis. As the discount rate gets larger, the difference in potential "life-years" between old and young gets smaller and the age bias is minimized. However, relegating a decision about the importance of patient age to a decision about the discount rate seems inappropriate. Value judgments cannot be avoided; therefore, it is best that they be explicit.
本文探讨了患者年龄在对政策制定者最具相关性的结果分析类型即成本效益分析中所起的作用。量化了年龄偏差的程度，并描述了修正它的方法。特别地，现值分析（贴现）被证明能显著减弱患者年龄对成本效益分析的影响。随着贴现率增大，老年人和年轻人潜在“生命年”的差异变小，年龄偏差最小化。然而，将关于患者年龄重要性的决策交由关于贴现率的决策来决定似乎并不合适。价值判断无法避免；因此，最好使其明确化。
