Jack Richardson

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Scaling instruments for the measurement of quality-adjusted life years (QALYs) incorporate either a personal or an impersonal perspective on the benefits of a health intervention and either do or do not incorporate considerations of equity. This paper sets out three hypotheses concerning perspective and equity: 1) that more equally distributed benefits will(More)
The paper addresses some limitations of the QALY approach and outlines a valuation procedure that may overcome these limitations. In particular, we focus on the following issues: the distinction between assessing individual utility and assessing societal value of health care; the need to incorporate concerns for severity of illness as an independent factor(More)
In a two-stage survey, a cross-section of Australians were questioned about the importance of costs in setting priorities in health care. Generally, respondents felt that it is unfair to discriminate against patients who happen to have a high cost illness and that costs should therefore not be a major factor in prioritising. The majority maintained this(More)
In most of the cost-utility literature, quality-adjusted life-year (QALY) gains are interpreted as a measure of social value. Given this interpretation, the validity of different multi-attribute health-state scaling instruments may be tested by comparing the values they provide on the 0-1 QALY scale with directly elicited preferences for person trade-offs(More)
The use of the Quality Adjusted Life-Year (QALY) as a measure of the benefit obtained from health care expenditure has been attacked on the ground that it gives a lower value to preserving the lives of people with a permanent disability or illness than to preserving the lives of those who are healthy and not disabled. The reason for this is that the quality(More)
OBJECTIVE Before cost-effectiveness analysis (CEA) can fulfill its promise as a tool to guide health care allocation decisions, the method of incorporating societal values into CEA may need to be improved. DESIGN The study design was a declarative exposition of potential fallacies in the theoretical underpinnings of CEA. Two values held by many(More)
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