The impact of considering adaptation in health state valuation.

Published

Journal Article

Patients with chronic health conditions often rate their quality of life (QoL) significantly higher than non-patients. One explanation for this discrepancy is that non-patients focus on the negative aspects of the onset of a condition, especially the early difficulties people face when they first experience a debilitating condition, without considering that patients can adapt to it over time. To test this hypothesis, we had 359 people perform person tradeoff (PTO) elicitations in an online survey, varying whether the treatment programs under consideration saved the lives of patients (a) with pre-existing paraplegia; or (b) who would experience new onset of paraplegia. Half of each group completed an "adaptation exercise" which encouraged them to consider their own ability to emotionally adapt to negative events in general and specifically to having paraplegia. The adaptation manipulation increased the value participants placed on pre-existing paraplegia (p=0.03) and on new onset paraplegia (p=0.05), relative to saving healthy lives. Moreover, the adaptation exercise dramatically reduced the differences between evaluations of pre-existing and new onset paraplegia to values within 2% of each other. Our findings suggest that asking non-patients to do an adaptation exercise before giving QoL ratings may help close the gap in ratings between patients and citizen non-patients.

Full Text

Duke Authors

Cited Authors

  • Damschroder, LJ; Zikmund-Fisher, BJ; Ubel, PA

Published Date

  • July 2005

Published In

Volume / Issue

  • 61 / 2

Start / End Page

  • 267 - 277

PubMed ID

  • 15893044

Pubmed Central ID

  • 15893044

Electronic International Standard Serial Number (EISSN)

  • 1873-5347

International Standard Serial Number (ISSN)

  • 0277-9536

Digital Object Identifier (DOI)

  • 10.1016/j.socscimed.2004.11.060

Language

  • eng