Gafni A, Birch S
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
Soc Sci Med. 1995 Mar;40(6):767-76. doi: 10.1016/0277-9536(94)e0109-6.
In this paper we critically appraise the appropriateness and validity from an economic perspective of alternative preference-based approaches to measuring outcomes in economic evaluations of health care interventions. We describe the properties of an outcome measure for economic evaluation to make it compatible with the principles of economics when applied to the problem of resource allocation. We also describe the difference and similarities between the psychometric and the economic approaches for the measurement of outcome. Using these properties we critically appraise the use of QALY and HYE methods of measuring individual and social preferences for health outcome. We argue that the most advanced measure currently available that meets these required properties is the HYE. Because the HYE, unlike the QALY, has its foundations in utility theory under uncertainty, it neither assumes particular formulations of the individual utility function, nor is it incompatible with the principles of economics. As such it represents a further stage in the continuing development of methods for economic evaluation of health care programmes.
在本文中，我们从经济学角度批判性地评估了在医疗保健干预措施的经济评估中，基于偏好的替代方法在衡量结果方面的适当性和有效性。我们描述了经济评估结果指标的属性，使其在应用于资源分配问题时与经济学原理相兼容。我们还描述了心理测量方法和经济测量方法在结果测量方面的异同。利用这些属性，我们批判性地评估了使用QALY（质量调整生命年）和HYE（健康年当量）方法来衡量个人和社会对健康结果的偏好。我们认为，目前可用的符合这些所需属性的最先进指标是HYE。因为与QALY不同，HYE基于不确定性下的效用理论，它既不假设个体效用函数的特定形式，也与经济学原理不相容。因此，它代表了医疗保健项目经济评估方法持续发展的又一阶段。
