A Time Trade-Off Method to Elicit Preferences of Spouses About the Influnce of Their Partners' Potential Prostate Cancer Health States on Them

Posted: 14 Jun 2007

See all articles by Anirban Basu

Anirban Basu

University of Chicago - Department of Medicine

Arthur Elstein

University of Illinois at Chicago

William Dale

University of Chicago

David Meltzer

University of Chicago - Departments of Medicine and Economics, and Harris School

Date Written: June 10, 2007

Abstract

Background: Medical cost-effectiveness analyses (CEA) traditionally treat patients as isolated individuals and neglect the effects of improvement in patients' health on the welfare of their family members. Recent analyses of the theoretical foundations of CEA suggest that cost-effectiveness analyses may better reflect the full costs and benefits of medical interventions if they incorporate these family effects. However, there is dearth of methods for measuring these spillover effects using preference-based approaches. Objective: To develop and apply a time trade-off (TTO) technique to measure the impact on the quality of life of spouses due to potential prostate cancer-related health states of their partners. Methods: In an ongoing study, we used standard TTO questions to measure utilities of male patients at the biopsy clinic who are at risk of developing prostate cancer for various prostate cancer health states. In an add-on pilot study, we developed modified TTO questions that ask a spouse of a patient to trade-off her own life in order to reduce the burden that she herself expects to experience if her partner develops one of the prostate cancer related health states. We review the theoretical justification for this question and carefully frame the question so as to reduce measurement error and also to avoid possible double counting with the effect on the partner's health. Results: We collected data from 26 spouses about their preferences for their own health, which is influenced by the patient's health condition. We find that the average quality of life weights for the spouses when the patients are healthy, impotent, incontinent, metastatic or dead are 0.81, 0.66, 0.68, 0.50 and 0.28 respectively. We find evidence of good face, convergent, divergent and concurrent validity with these time-trade-off questions. Furthermore, we matched the preferences of the spouses with those of the patients on the same health states and found that these preferences were either uncorrelated or negatively correlated, implying that the spouses were not acting as proxies for the patient. Conclusions: Preliminary results show that this new time-trade-off method produces valid measurements of the spillover effect on family member's QOL.

Keywords: utilities, quality of life, spouses, cost-effectiveness, prostate cancer, time trade-off

JEL Classification: C81, D62, D13

Suggested Citation

Basu, Anirban and Elstein, Arthur and Dale, William and Meltzer, David Owen, A Time Trade-Off Method to Elicit Preferences of Spouses About the Influnce of Their Partners' Potential Prostate Cancer Health States on Them (June 10, 2007). iHEA 2007 6th World Congress: Explorations in Health Economics Paper. Available at SSRN: https://ssrn.com/abstract=992836

Anirban Basu (Contact Author)

University of Chicago - Department of Medicine ( email )

5841 S. Maryland Ave
MC-2007
Chicago, IL 60637
United States
773 834 1796 (Phone)
773 834 2238 (Fax)

HOME PAGE: http://home.uchicago.edu/~abasu

Arthur Elstein

University of Illinois at Chicago ( email )

1200 W Harrison St
Chicago, IL 60607
United States

William Dale

University of Chicago ( email )

1101 East 58th Street
Chicago, IL 60637
United States

David Owen Meltzer

University of Chicago - Departments of Medicine and Economics, and Harris School ( email )

5841 S. Maryland Ave.
B-220
Chicago, IL 60637
United States

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