Lal Anita, Siahpush Mohammad, Moodie Marjory, Peeters Anna, Carter Robert
School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia.
Department of Health Promotion, Social & Behavioral Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE, 68198-4365, USA.
Pharmacoecon Open. 2018 Mar;2(1):43-51. doi: 10.1007/s41669-017-0036-1.
The trade-off that society is willing to make to promote a more equitable distribution of health can be represented as a social welfare function (SWF). SWFs are an economic construct that can be used to illustrate concerns for total health with aversion to inequalities between socioeconomic groups.
This study used people's preferences to estimate the shapes of health-related SWFs (HRSWFs). We tested the suitability of this method to derive equity weights.
A questionnaire was used to elicit preferences concerning trade-offs between the total level of health and its distribution among two socioeconomic groups. The participant group was a sample of convenience that included a mix of health researchers, academics, clinicians, managers, public servants and research students. The data collected were used to develop HRSWFs with a constant elasticity of substitution. The weight was calculated using the marginal rate of substitution.
A marginal health gain to the lowest socioeconomic position (SEP) group was valued 14.1-81.4 times more than a marginal health gain to the high SEP group.
Our results provide evidence to support the idea that the public may be willing to make trade-offs between efficiency and equity, and that they value health gains differently depending on which socioeconomic group receives the health gain. Further evidence is required before such indicative weights have practical value.
社会为促进更公平的健康分配而愿意做出的权衡可以用社会福利函数（SWF）来表示。社会福利函数是一种经济结构，可用于说明对总体健康的关注以及对社会经济群体之间不平等的厌恶。
本研究利用人们的偏好来估计与健康相关的社会福利函数（HRSWF）的形状。我们测试了这种方法得出公平权重的适用性。
使用一份问卷来获取关于健康总体水平与其在两个社会经济群体之间分配的权衡的偏好。参与组是一个便利样本，包括健康研究人员、学者、临床医生、管理人员、公务员和研究生。收集到的数据用于开发具有固定替代弹性的与健康相关的社会福利函数。权重使用边际替代率来计算。
社会经济地位最低（SEP）组的边际健康收益比社会经济地位高的组的边际健康收益高出14.1至81.4倍。
我们的结果提供了证据支持公众可能愿意在效率与公平之间做出权衡这一观点，并且他们根据获得健康收益的社会经济群体不同而对健康收益的重视程度也不同。在这种指示性权重具有实际价值之前，还需要进一步的证据。
