School of Health and Related Research, Department of Economics, University of Sheffield, Sheffield, UK.
Value Health. 2010 Mar-Apr;13(2):298-305. doi: 10.1111/j.1524-4733.2009.00614.x. Epub 2009 Sep 25.
In 1996 the Washington Panel controversially recommended valuing productivity costs (PC) in terms of quality-adjusted life years. The Panel's assumption that respondents in health state valuation (HSV) exercises take income losses into account could not be countered since there was no evidence regarding what people consider in HSV exercises. If they do consider income losses and if this changes HSVs, then all economic evaluations that have included PC in the numerator may have double-counted these costs. Alternatively, if respondents do not consider income losses then all past economic evaluations that have not included PC in the numerator have failed to account for sizeable societal costs.
Through a review we aim to recapture the debate surrounding the appropriate method for including PC in health economic evaluations, to identify empirical evidence addressing the assumptions of the Panel, and recommend a future research agenda.
Through a review we identify, outline, and critically appraise the existing empirical studies that attempt to address whether respondents include income effects in HSV exercises.
Seven empirical studies were identified. Overall, it seems that not explicitly mentioning the inclusion of income will induce a minority of respondents to include these effects and this appears not to influence results. More empirical work is needed, using generic instruments, larger samples, and using the interview method of administration.
1996 年，华盛顿小组颇具争议地建议根据质量调整生命年来衡量生产力成本（PC）。小组关于健康状态估值（HSV）练习中的受访者会考虑收入损失的假设无法被反驳，因为没有证据表明人们在 HSV 练习中会考虑哪些因素。如果他们确实考虑了收入损失，并且这会改变 HSV，那么所有包含 PC 作为分子的经济评估可能都已经重复计算了这些成本。或者，如果受访者不考虑收入损失，那么所有过去不包含 PC 作为分子的经济评估都没有考虑到相当大的社会成本。
通过回顾，我们旨在重新探讨将 PC 纳入健康经济评估的适当方法，以确定解决小组假设的经验证据，并为未来的研究议程提供建议。
通过回顾，我们确定、概述和批判性地评价了试图确定受访者是否在 HSV 练习中包含收入效应的现有经验研究。
确定了 7 项经验研究。总体而言，似乎不明确提及收入的包含会促使少数受访者包含这些效应，而且这似乎不会影响结果。需要更多的实证工作，使用通用工具、更大的样本，并采用访谈法进行管理。
