Abstract
New health technologies are being developed, while public healthcare resources are limited. This situation makes prioritizing in the healthcare sector inevitable.
Health benefit, resource use and severity are the priority criteria on which the allocation of healthcare resources in Norway should be based. The quality-adjusted life-year (QALY) is used to operationalize these criteria. The QALY provides a combined measure of life length and health-related quality of life (HRQoL). This thesis addresses methodological challenges when measuring and valuing health for QALY calculations.
Insights from psychometrics and health economics have been applied to help explain why different values get assigned to the same health state when using different instruments.
Qualitative research methods have been used to explore to what extent a patient group with mobility impairments can describe their mobility-related health status with currently used instruments. The findings indicate that not all instruments allow all respondent groups to represent their health states adequately.
Quantitative research methods have been applied to achieve the following:
- replicate the original 15D valuation method,
- compare Finnish and Norwegian 15D health state values,
- suggest a new 15D valuation method that reflects respondent’s preferences more adequately.
The new 15D valuation method has been used to estimate the first value algorithm based on preferences of the general Norwegian population. This allows decision makers to incorporate Norwegian preferences in the allocation of health care resources.