Abstract
Background Patients with a permanent impairment may be unable to reach full health. Consequently health services which cure illnesses which are unrelated to the impairment may increase health less than services for patients with no impairment. While it has been argued that this should not lead to discrimination against impaired patients there is little evidence to determine whether this equity-efficiency trade-off is consistent with social values. Objectives To measure the effect of permanent impairment upon the social valuation of services for unrelated illnesses. Methods Social valuations of services for illnesses associated with mobility, depression or pain were assessed and compared for patients with and without a permanent impairment using the Relative Social Willingness to Pay (RS-WTP) instrument. The maximum valuation of services for impaired patients was also compared with the maximum utility which could be gained when utility was measured using three multi attribute utility instruments. Results Curing the illness of impaired patients was valued 8–11 percent less than the cure of patients with no impairment. Discrimination decreased as the severity of the illness increased. Valuation of health states using the utility instruments implied significantly greater discrimination than the social valuations using the RS-WTP instrument. Conclusions Health services are valued less highly when a patient’s health potential is impaired. However discrimination is significantly less than would occur if the value of the services were limited to the value of the health state causing the impairment. The argument for disregarding a patient’s limited health potential when resources are allocated therefore receives some support from social valuations but the case for completely equal treatment depends upon additional ethical arguments.
| Original language | English |
|---|---|
| Article number | e0192585 |
| Number of pages | 15 |
| Journal | PLoS ONE |
| Volume | 13 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1 Apr 2018 |
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Does a patient’s health potential affect the social valuation of health services? / Richardson, Jeff; Iezzi, Angelo; Maxwell, Aimee.
In: PLoS ONE, Vol. 13, No. 4, e0192585, 01.04.2018.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Does a patient’s health potential affect the social valuation of health services?
AU - Richardson, Jeff
AU - Iezzi, Angelo
AU - Maxwell, Aimee
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Background Patients with a permanent impairment may be unable to reach full health. Consequently health services which cure illnesses which are unrelated to the impairment may increase health less than services for patients with no impairment. While it has been argued that this should not lead to discrimination against impaired patients there is little evidence to determine whether this equity-efficiency trade-off is consistent with social values. Objectives To measure the effect of permanent impairment upon the social valuation of services for unrelated illnesses. Methods Social valuations of services for illnesses associated with mobility, depression or pain were assessed and compared for patients with and without a permanent impairment using the Relative Social Willingness to Pay (RS-WTP) instrument. The maximum valuation of services for impaired patients was also compared with the maximum utility which could be gained when utility was measured using three multi attribute utility instruments. Results Curing the illness of impaired patients was valued 8–11 percent less than the cure of patients with no impairment. Discrimination decreased as the severity of the illness increased. Valuation of health states using the utility instruments implied significantly greater discrimination than the social valuations using the RS-WTP instrument. Conclusions Health services are valued less highly when a patient’s health potential is impaired. However discrimination is significantly less than would occur if the value of the services were limited to the value of the health state causing the impairment. The argument for disregarding a patient’s limited health potential when resources are allocated therefore receives some support from social valuations but the case for completely equal treatment depends upon additional ethical arguments.
AB - Background Patients with a permanent impairment may be unable to reach full health. Consequently health services which cure illnesses which are unrelated to the impairment may increase health less than services for patients with no impairment. While it has been argued that this should not lead to discrimination against impaired patients there is little evidence to determine whether this equity-efficiency trade-off is consistent with social values. Objectives To measure the effect of permanent impairment upon the social valuation of services for unrelated illnesses. Methods Social valuations of services for illnesses associated with mobility, depression or pain were assessed and compared for patients with and without a permanent impairment using the Relative Social Willingness to Pay (RS-WTP) instrument. The maximum valuation of services for impaired patients was also compared with the maximum utility which could be gained when utility was measured using three multi attribute utility instruments. Results Curing the illness of impaired patients was valued 8–11 percent less than the cure of patients with no impairment. Discrimination decreased as the severity of the illness increased. Valuation of health states using the utility instruments implied significantly greater discrimination than the social valuations using the RS-WTP instrument. Conclusions Health services are valued less highly when a patient’s health potential is impaired. However discrimination is significantly less than would occur if the value of the services were limited to the value of the health state causing the impairment. The argument for disregarding a patient’s limited health potential when resources are allocated therefore receives some support from social valuations but the case for completely equal treatment depends upon additional ethical arguments.
UR - http://www.scopus.com/inward/record.url?scp=85045887586&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0192585
DO - 10.1371/journal.pone.0192585
M3 - Article
VL - 13
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 4
M1 - e0192585
ER -