A Method to Elicit Utilities for Interpersonal Comparisons

Abstract

This paper examines how values should be assigned to health states when policy decisions must be made about who should receive treatment. The paper demonstrates that, if priority were to be assigned to those people who would benefit most from treatment, standard health-state utilities might fail to identify resource allocations that would maximize total health-related well-being in society. A new measurement instru ment is proposed that is based on the direct comparison of the well-being achieved by different people in various health states and thus captures such community priori ties. A sample of 72 health administration students used the instrument to evaluate speech and mobility dysfunctions as they afflicted hypothetical people who differed by gender, family status, and occupational type. This preliminary analysis indicates that the instrument is feasible to use, and that the valuations of respondents did, for some health conditions, significantly depend on the type of person afflicted. Key words: util ities ; interpersonal comparisons; ethics; health policy; extended-sympathy instrument. (Med Decis Making 1997;17:10-20)