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- Article] Individual Health Discount Rate in Patients with Ulcerative Colitis
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DocNo of ILP: 1997
Doc. Type: Article
Title: Individual Health Discount Rate in Patients with Ulcerative Colitis
Authors: Waljee, AK; Morris, AM; Waljee, JF; Higgins, PDR
Full Name of Authors: Waljee, Akbar K.; Morris, Arden M.; Waljee, Jennifer F.; Higgins, Peter D. R.
Keywords by Author: ulcerative colitis; discount rates; quality of life; utilities
Keywords Plus: COST-EFFECTIVENESS ANALYSIS; INFLAMMATORY-BOWEL-DISEASE; CARE INTERVENTIONS; DECISION-MAKING; TIME PREFERENCE; TOBIT-MODEL; RISK; BENEFITS
Abstract: Background: In cost-effectiveness analysis, discount rates are used in calculating the value of future costs and benefits. However, standard discount rates may not accurately describe the decision-making of patients with ulcerative colitis (UC). These patients often choose the long-term risks of immunosuppressive therapy over the short-term risks of colectomy, demonstrating very high discount rates for future health. In this study we aimed to measure the discount rate in UC patients and identify variables associated with the discount rate. Methods: We surveyed patients with UC and patients who were postcolectomy for UC to measure their valuations of UC and colectomy health states. We used Standard Gamble (SG) and Time-Trade-Off (TTO) methods to assess current and future health state valuations and calculated the discount rate. Results: Participants included 150 subjects with UC and 150 subjects who were postcolectomy for UC. Adjusted discount rates varied widely (0%-100%), with an overall median rate of 55.0% (interquartile range [IQR] 20.6-100), which was significantly higher than the standard rate of 5%. Within the normal range of discount rates, patients' expected discount rate increased by 0.80% for each additional year of age, and female patients had discount rates that averaged approximate to 8% less than their age-matched counterparts and approached statistical significance. Conclusions: The accepted discount rate of 5% grossly underestimates UC patients' preference for long-term over short-term risk. This might explain UC patients' frequent choice of the long-term risks of immunosuppressive medical therapy over the short-term risks of colectomy.
Cate of OECD: Clinical medicine
Year of Publication: 2011
Business Area: gamble
Detail Business: gamble
Country: USA
Study Area:
Name of Journal: INFLAMMATORY BOWEL DISEASES
Language: English
Country of Authors: [Waljee, Akbar K.; Higgins, Peter D. R.] Univ Michigan, Dept Internal Med, Div Gastroenterol, Ann Arbor, MI 48109 USA; [Morris, Arden M.; Waljee, Jennifer F.] Univ Michigan, Dept Gen Surg, Ann Arbor, MI 48109 USA
Press Adress: Waljee, AK (reprint author), Univ Michigan, Dept Internal Med, Div Gastroenterol, 6520 MSRB I,Box 0682,1150 W Med Ctr Dr, Ann Arbor, MI 48109 USA.
Email Address: awaljee@med.umich.edu
Citaion: Higgins, Peter/0000-0003-1602-4341; Waljee, Akbar/0000-0003-1964-8790;
Funding: American Society of Colon and Rectal Surgeons Limited [078]
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Number of Citaion: 26
Publication: WILEY-BLACKWELL
City of Publication: MALDEN
Address of Publication: COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA
ISSN: 1078-0998
29-Character Source Abbreviation: INFLAMM BOWEL DIS
ISO Source Abbreviation: Inflamm. Bowel Dis.
Volume: 17
Version: 6
Start of File: 1328
End of File: 1332
DOI: 10.1002/ibd.21515
Number of Pages: 5
Web of Science Category: Gastroenterology & Hepatology
Subject Category: Gastroenterology & Hepatology
Document Delivery Number: 761ZQ
Unique Article Identifier: WOS:000290442400031
[이 게시물은 HyeJung Mo…님에 의해 2015-05-20 20:21:01 GAMBLING에서 이동 됨]
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