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Rodríguez-Míguez E, Sampayo A. Comparison of Caregiver and General Population Preferences for Dependency-Related Health States. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024:10.1007/s40258-024-00908-x. [PMID: 39256323 DOI: 10.1007/s40258-024-00908-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 09/12/2024]
Abstract
OBJECTIVE We assess whether the preferences regarding dependency-related health states as stated by informal caregivers are aligned with those expressed by the general population. METHODS The preferences of a sample of 139 Spanish informal caregivers of dependent patients are compared with those obtained via a sample of 312 persons, also from the Spanish general population. We assess 24 dependency states extracted from the DEP-6D using the time trade-off method. Descriptive statistics and regression methods are used to explore differences between the two samples. RESULTS Mean difference tests establish that, for all but one of the 24 states, there are no significant differences between the samples. The estimated mean values ranged from - 0.64 to 0.60 for the caregiver sample and from - 0.60 to 0.65 for the general population sample, with a correlation of 0.96. On average, the classification of states as better or worse than dead matched in both samples (except for one state). Regression models also show that sample type does not have a significant average impact. After we introduce interaction effects, only the most severe level of two dimensions, cognitive problems and housework, result in significant differences-with the caregiver sample reporting higher values for the former, and lower values for the latter. CONCLUSION Caregivers and the general population exhibit quite similar preferences concerning dependency-related health states. This suggests that the results of cost-utility analyses, and the resource allocation decisions based on them, would likewise not be significantly affected by the preferences used to generate the weighting algorithm.
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Affiliation(s)
- Eva Rodríguez-Míguez
- ECOBAS, Universidade de Vigo, GRIEE, 36310, Vigo, Spain.
- Instituto de Investigación Sanitaria Galicia Sur, Hospital Álvaro Cunqueiro, 36213, Vigo, Spain.
| | - Antonio Sampayo
- ECOBAS, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain
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Nguyen L, Jokimäki H, Linnosmaa I, Saloniki EC, Batchelder L, Malley J, Lu H, Burge P, Trukeschitz B, Forder J. Valuing informal carers' quality of life using best-worst scaling-Finnish preference weights for the Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer). THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:357-374. [PMID: 34468882 PMCID: PMC8964536 DOI: 10.1007/s10198-021-01356-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
This study developed Finnish preference weights for the seven-attribute Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer) and investigated survey fatigue and learning in best-worst scaling (BWS) experiments. An online survey that included a BWS experiment using the ASCOT-Carer was completed by a sample from the general population in Finland. A block of eight BWS profiles describing different states from the ASCOT-Carer were randomly assigned to each respondent, who consecutively made four choices (best, worst, second best and second worst) per profile. The analysis panel data had 32,160 choices made by 1005 respondents. A scale multinomial logit (S-MNL) model was used to estimate preference weights for 28 ASCOT-Carer attribute levels. Fatigue and learning effects were examined as scale heterogeneity. Several specifications of the generalised MNL model were employed to ensure the stability of the preference estimates. The most and least-valued states were the top and bottom levels of the control over daily life attribute. The preference weights were not on a cardinal scale. We observed the position effect of the attributes on preferences associated with the best or second-best choices. A learning effect was found. The established preference weights can be used in evaluations of the effects of long-term care services and interventions on the quality of life of service users and caregivers. The learning effect implies a need to develop study designs that ensure equal consideration to all profiles (choice tasks) in a sequential choice experiment.
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Affiliation(s)
- Lien Nguyen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
| | - Hanna Jokimäki
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ismo Linnosmaa
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Eirini-Christina Saloniki
- Centre for Health Services Studies (CHSS), University of Kent, Kent, UK
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Laurie Batchelder
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Juliette Malley
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Hui Lu
- RAND Europe, Cambridge, UK
| | | | - Birgit Trukeschitz
- Research Institute for Economics of Aging, WU Vienna University of Economics and Business, Vienna, Austria
| | - Julien Forder
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
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Nakamura-Thomas H, Yamaguchi M, Yamaguchi I, Rand S. Assessing the Structural Characteristics of the Japanese Version of the Adult Social Care Outcomes Toolkit for Carers. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223211030269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Due to the absence of standardized Quality of Life (QoL) measures for informal family caregivers of recipients of long-term care (LTC) in Japan, translation and cross-cultural adapted LTC outcome measures are needed for research and evaluation. In this study, we assessed the validity and reliability of the factor structure and response system of the translated and cross-culturally adapted Japanese version of the Adult Social Care Outcomes Toolkit for Carer (J-ASCOT-Carer). Participants were 872 informal family caregivers of adults who lived at home and required LTC services. Almost half (46%) of the participants were between 50 and 59 years old, 85% were employed, and 69% resided with their care recipients. We used the combined factor analysis and item response theory approach. Model fit indices included factor loading, path coefficients, root mean square error of approximation, standardized root mean square residual, and comparative fit index. This study confirmed the one factor structure that was identified in the original English version of the ASCOT-Carer. The values for the model fit indices indicated a good fit. Moreover, the validity and reliability of the response system were confirmed. Therefore, the J-ASCOT-Carer is a reliable assessment instrument to measure QoL of Japanese caregivers of adults requiring LTC.
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Shiroiwa T, Nakamura-Thomas H, Yamaguchi M, Morikawa M, Moriyama Y, Fukuda T, Allan S, Malley J. Japanese preference weights of the Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer). Qual Life Res 2022; 31:2143-2151. [PMID: 35020110 PMCID: PMC8752387 DOI: 10.1007/s11136-021-03076-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 11/29/2022]
Abstract
Purpose We developed preference weights of the Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer) in Japan. Methods We used best–worst scaling (BWS) and composite time trade-off (cTTO) to determine the preference weights for ASCOT-Carer states in the general population. TTO values were applied to convert the BWS scores to utilities. The sample number was approximately 1000 for the BWS survey and 200 for the TTO survey. Whereas face-to-face surveys by computer-assisted interviewing were adopted for the TTO tasks, a web-based survey was used for the BWS tasks. In the BWS tasks, the ASCOT-Carer states were presented, and the “best,” “worst,” “second best,” and “second worst” domains in a profile were selected. A mixed logit model was applied to the BWS data. Results The respondents’ background was similar to that of the general population, although the number of people in the age and sex categories was equal. The preference weights for calculating the utilities of the ASCOT-Carer states were estimated. The estimated utilities of the ASCOT-Carer states were distributed between 1 and 0.02. All preference weights were consistent. The item with the highest preference weight was level 1 in the “space and time to be yourself.” The least preferred item was level 4 in the “space and time to be yourself” and “control over daily life” domains. Conclusion We established Japanese preference weights for ASCOT-Carer states, the first weights of an Asian country. The estimated utilities can contribute to the measurement of caregivers’ social care-related QoL and perform of cost-effectiveness analyses. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-03076-w.
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Affiliation(s)
- Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - Hiromi Nakamura-Thomas
- Graduate School of Health, Medicine and Welfare, School of Occupational Therapy, Saitama Prefectural University, 820 Sannomiya, Koshigaya, Saitama, 343-8540, Japan
| | - Mai Yamaguchi
- Japan Lutheran College, 3-10-20 Osawa, Mitaka, Tokyo, 181-0015, Japan
| | - Mie Morikawa
- Department of Policy Studies, Tsuda University, 1-18-24 Sendagaya, Shibuya-ku, Tokyo, 151-0051, Japan
| | - Yoko Moriyama
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Stephen Allan
- Personal Social Services Research Unit (PSSRU), University of Kent, Canterbury, CT2 7NF, Kent, UK
| | - Juliette Malley
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
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Nguyen L, Jokimäki H, Linnosmaa I, Saloniki EC, Batchelder L, Malley J, Lu H, Burge P, Trukeschitz B, Forder J. Do You Prefer Safety to Social Participation? Finnish Population-Based Preference Weights for the Adult Social Care Outcomes Toolkit (ASCOT) for Service Users. MDM Policy Pract 2021; 6:23814683211027902. [PMID: 34291174 PMCID: PMC8274113 DOI: 10.1177/23814683211027902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/01/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction. The Adult Social Care Outcomes Toolkit (ASCOT) was developed in England to measure people’s social care–related quality of life (SCRQoL). Objectives. The aim of this article is to estimate preference weights for the Finnish ASCOT for service users (ASCOT). In addition, we tested for learning and fatigue effects in the choice experiment used to elicit the preference weights. Methods. The analysis data (n = 1000 individuals) were obtained from an online survey sample of the Finnish adult general population using gender, age, and region as quotas. The questionnaire included a best-worst scaling (BWS) experiment using ASCOT. Each respondent sequentially selected four alternatives (best, worst; second-best, second-worst) for eight BWS tasks (n = 32,000 choice observations). A scale multinomial logit model was used to estimate the preference parameters and to test for fatigue and learning. Results. The most and least preferred attribute-levels were “I have as much control over my daily life as I want” and “I have no control over my daily life.” The preference weights were not on a cardinal scale. The ordering effect was related to the second-best choices. Learning effect was in the last four tasks. Conclusions. This study has developed a set of preference weights for the ASCOT instrument in Finland, which can be used for investigating outcomes of social care interventions on adult populations. The learning effect calls for the development of study designs that reduce possible bias relating to preference uncertainty at the beginning of sequential BWS tasks. It also supports the adaptation of a modelling strategy in which the sequence of tasks is explicitly modelled as a scale factor.
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Affiliation(s)
- Lien Nguyen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Hanna Jokimäki
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ismo Linnosmaa
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - Laurie Batchelder
- Personal Social Services Research Unit, University of Kent, Kent, UK
| | - Juliette Malley
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Hui Lu
- RAND Europe, Cambridge, UK
| | | | - Birgit Trukeschitz
- Research Institute for Economics of Aging, WU Vienna University of Economics and Business, Vienna, Austria
| | - Julien Forder
- Personal Social Services Research Unit, University of Kent, Kent, UK
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