Is “end of life” a special case? Connecting Q with survey methods to measure societal support for views on the value of life-extending treatments

Helen Mason*, Marissa Collins, Neil McHugh, Jon Godwin, Job van Exel, Cam Donaldson, Rachel Baker

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Preference elicitation studies reporting societal views on the relative value of end of life treatments have produced equivocal results. This paper presents an alternative method, combining Q methodology and survey techniques (Q2S) to determine the distribution of three viewpoints on the relative value of end of life treatments identified in a previous, published, phase of this work. These were: Viewpoint 1, ‘A population perspective: value for money, no special cases’; Viewpoint 2, ‘Life is precious: valuing life-extension and patient choice’; and Viewpoint 3, ‘Valuing wider benefits and opportunity cost: the quality of life and death’.

A Q2S survey of 4,902 respondents across the UK measured agreement with these viewpoints; 37% most agreed with Viewpoint 1, 49% with Viewpoint 2 and 9% with Viewpoint 3. Regression analysis showed associations of viewpoints with gender, level of education, religion, voting preferences and satisfaction with the NHS.

The Q2S approach provides a promising means to investigate how in-depth views and opinions are represented in the wider population. As demonstrated in this study, there is often more than one viewpoint on a topic and methods that seek to estimate averages may not provide the best guidance for societal decision making.
Original languageEnglish
Pages (from-to)819-831
Number of pages13
JournalHealth Economics
Volume27
Issue number5
Early online date19 Jan 2018
DOIs
Publication statusPublished - May 2018

Keywords

  • end of life
  • Q survey
  • resource allocation
  • societal views

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