Institute of Economics, Centre for Economic and Regional Studies, Tóth Kálmán u 4., Budapest, 1097, Hungary.
Institute of Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary.
Eur J Health Econ. 2022 Sep;23(7):1243-1255. doi: 10.1007/s10198-021-01424-8. Epub 2022 Jan 5.
Acceptable health and sufficientarianism are emerging concepts in health resource allocation. We defined acceptability as the proportion of the general population who consider a health state acceptable for a given age. Previous studies surveyed the acceptability of health problems separately per EQ-5D-3L domain, while the acceptability of health states with co-occurring problems was barely explored.
To quantify the acceptability of 243 EQ-5D-3L health states for six ages from 30 to 80 years: 1458 health state-age combinations (HAcs), denoted as the acceptability set of EQ-5D-3L.
In 2019, an online representative survey was conducted in the Hungarian general population. We developed a novel adaptive survey algorithm and a matching statistical measurement model. The acceptability of problems was evaluated separately per EQ-5D-3L domain, followed by joint evaluation of up to 15 HAcs. The selection of HAcs depended on respondents' previous responses. We used an empirical Bayes measurement model to estimate the full acceptability set.
1375 respondents (female: 50.7%) were included with mean (SD) age of 46.7 (14.6) years. We demonstrated that single problems that were acceptable separately for a given age were less acceptable when co-occurring jointly (p < 0.001). For 30 years of age, EQ-5D-3L health states of '11112' (11.9%) and '33333' (1%), while for 80 years of age '21111' (93.3%) and '33333' (7.4%) had highest and lowest acceptability (% of population), respectively.
The acceptability set of EQ-5D-3L quantifies societal preferences concerning age and disease severity. Its measurement profiles and potential role in health resource allocation needs further exploration.
可接受性和足够主义是卫生资源分配中的新兴概念。我们将可接受性定义为一般人群中认为特定年龄的健康状况可接受的比例。以前的研究分别调查了 EQ-5D-3L 每个领域的健康问题的可接受性，而几乎没有探索同时存在健康问题的健康状况的可接受性。
量化 EQ-5D-3L 从 30 岁到 80 岁的 6 个年龄段的 243 个健康状态的可接受性：1458 个健康状态-年龄组合（HAc），表示为 EQ-5D-3L 的可接受性集。
2019 年，在匈牙利普通人群中进行了一项在线代表性调查。我们开发了一种新的自适应调查算法和匹配的统计测量模型。按 EQ-5D-3L 每个领域分别评估问题的可接受性，然后对多达 15 个 HAc 进行联合评估。HAc 的选择取决于受访者的先前反应。我们使用经验贝叶斯测量模型来估计完整的可接受性集。
1375 名受访者（女性：50.7%）参与了调查，平均年龄为 46.7（14.6）岁。我们证明，对于给定年龄单独可接受的单个问题，当共同出现时，其可接受性较低（p < 0.001）。对于 30 岁，EQ-5D-3L 健康状态“11112”（11.9%）和“33333”（1%）具有最高和最低的可接受性（人口百分比），而对于 80 岁，“21111”（93.3%）和“33333”（7.4%）具有最高和最低的可接受性（人口百分比）。
EQ-5D-3L 的可接受性集量化了社会对年龄和疾病严重程度的偏好。它的测量分布及其在卫生资源分配中的潜在作用需要进一步探索。
