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俄罗斯的健康状态评估:首次可行性研究

Valuing Health States in Russia: A First Feasibility Study.

作者信息

Khabibullina Alina, Gerry Christopher J

机构信息

International Centre for Health Economics, Management, and Policy, National Research University Higher School of Economics, St. Petersburg, Russia.

Oxford School of Global and Area Studies, University of Oxford, Oxford, England, UK; Institute for Social Analysis and Forecasting of The Russian Presidential Academy of National Economy and Public Administration RANEPA, Moscow, Russia.

出版信息

Value Health Reg Issues. 2019 Sep;19:75-80. doi: 10.1016/j.vhri.2019.01.005. Epub 2019 Jun 7.

Abstract

OBJECTIVE

The aim of this study was to explore the feasibility of different health-related quality-of-life valuation methods in a new setting. Based on a small feasibility study of 100 young Russians, we trialed different methodologies and identified key differences that have implications for the development of health technology assessment in Russia.

METHODS

In face-to-face interviews, respondents completed a series of health self-assessments based on a modified version of the EQ-5D-3L, visual analogue scale, time tradeoff, standard gamble, and best-worst scaling methodologies, covering actual and hypothetical health states.

RESULTS

We found that (1) the visual analogue scale produced lower health valuations and fewer logical inconsistencies than either time trade-off or standard gamble methodologies; (2) initial health states can be decisive in determining values assigned to health improvements; (3) respondents evaluate abstract health states more positively than their own actual health states; (4) there is evidence consistent with the hypothesis that actual and hypothetical health state valuation, using EQ-5D-3L, is an artifact of understanding rather than preference and that the incorporation of additional levels may therefore be no panacea if the dimensions themselves overlook important attributes; and (5) the country context is important in determining how respondents relate to the survey tools and how those survey tools are translated and delivered.

CONCLUSIONS

Russia is commencing its health technology assessment journey and should proceed cautiously as it moves toward the valuation of health benefits. These results suggest a useful framework for a more in-depth development of health valuation methodologies in Russia.

摘要

目的

本研究旨在探讨在新环境中不同健康相关生活质量评估方法的可行性。基于对100名俄罗斯年轻人的小型可行性研究,我们试用了不同方法,并确定了对俄罗斯卫生技术评估发展有影响的关键差异。

方法

在面对面访谈中,受访者基于EQ-5D-3L的修改版、视觉模拟量表、时间权衡法、标准博弈法和最佳-最差标度法完成了一系列健康自我评估,涵盖实际和假设的健康状态。

结果

我们发现:(1)视觉模拟量表产生的健康估值低于时间权衡法或标准博弈法,且逻辑不一致情况更少;(2)初始健康状态在确定赋予健康改善的价值时可能起决定性作用;(3)受访者对抽象健康状态的评价比对自身实际健康状态的评价更积极;(4)有证据支持以下假设:使用EQ-5D-3L对实际和假设健康状态进行估值是理解的产物而非偏好,因此,如果维度本身忽略了重要属性,增加更多水平可能并非万灵药;(5)国家背景对于确定受访者与调查工具的关系以及这些调查工具如何翻译和提供很重要。

结论

俄罗斯正开始其卫生技术评估之旅,在迈向健康效益评估时应谨慎行事。这些结果为俄罗斯更深入发展健康评估方法提供了一个有用的框架。

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