Hoogenboom Ava F H, Lipman Stefan A
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3062 PA, The Netherlands.
Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3062 PA, The Netherlands.
Eur J Health Econ. 2025 Apr 12. doi: 10.1007/s10198-025-01775-6.
Earlier work has shown that adults valuing health for 10-year-old children (i.e., in a child perspective) are more reluctant to trade-off life duration than for themselves, generating higher utilities in composite time trade-off (cTTO). The main motivation of this study is to explore if this reluctance can be explained through loss aversion, i.e., losses of life duration weighing more than gains of the same size.
100 UK adults completed cTTO tasks for six EQ-5D-Y-3L states and tasks measuring loss aversion. Both sets of tasks were completed from the child perspective and for the respondent themselves, enabling perspective-dependent correction for loss aversion.
A slight majority of participants was explicitly more loss averse for children than for themselves. Health state utilities were higher in the child perspective both before and after correction for loss aversion. Differences between utilities elicited in both perspectives and the variance of cTTO utilities increased considerably after correction.
The results suggest that loss aversion does not explain differences in willingness to trade-off life duration between perspectives. Hence, it remains unclear if correction for loss aversion should be recommended when using EQ-5D-Y-3L utilities in practice.
早期研究表明,从10岁儿童的角度(即从儿童视角)重视健康的成年人,比起为自己考虑,更不愿意权衡生命时长,在综合时间权衡法(cTTO)中产生更高的效用。本研究的主要目的是探讨这种不情愿是否可以通过损失厌恶来解释,即生命时长的损失比同等规模的收益更重要。
100名英国成年人完成了针对六种EQ-5D-Y-3L健康状态的cTTO任务以及测量损失厌恶的任务。这两组任务均从儿童视角以及为受访者自身完成,从而实现了基于视角的损失厌恶校正。
略超过半数的参与者明确表现出,比起为自己考虑,他们对儿童更厌恶损失。在对损失厌恶进行校正前后,从儿童视角得出的健康状态效用均更高。在两种视角下得出的效用差异以及cTTO效用的方差在校正后大幅增加。
结果表明,损失厌恶并不能解释不同视角下在权衡生命时长意愿上的差异。因此,在实际使用EQ-5D-Y-3L效用时,是否应推荐进行损失厌恶校正仍不明确。