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Could there be a single European EQ tariff?

Could there be a single European EQ tariff?. Jan J.V. Busschbach, Ph.D. Former address: iMTA, Erasmus university Present address: Medical Psychology and Psychotherapy Erasmus Medical Center, Rotterdam PO Box 1738 3000 DR Rotterdam, The Netherlands

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Could there be a single European EQ tariff?

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  1. Could there be a single European EQ tariff? • Jan J.V. Busschbach, Ph.D. • Former address: • iMTA, Erasmus university • Present address: • Medical Psychology and Psychotherapy • Erasmus Medical Center, Rotterdam • PO Box 1738 • 3000 DR Rotterdam, The Netherlands • Psychotherapeutic center “De viersprong” • PO Box 7 • 4660 AA Halsteren, The Netherlands • Busschbach@bmg.eur.nl

  2. The EuroQol • MOBILITY • I have no problems in walking about • I have some problems in walking about • I am confined to bed • SELF-CARE • I have no problems with self-care • I have some problems washing or dressing myself • I am unable to wash or dress myself • USUAL ACTIVITIES (e.g. work, study, housework family or leisure activities) • I have no problems with performing my usual activities • I have some problems with performing my usual activities • I am unable to perform my usual activities • PAIN/DISCOMFORT • I have no pain or discomfort • I have moderate pain or discomfort • I have extreme pain or discomfort • ANXIETY/DEPRESSION • I am not anxious or depressed • I am moderately anxious or depressed • I am extremely anxious or depressed • Links values from the general public to 243 health states • 5 dimensions, 3 levels • Starting point of group: QoL-values differ over Europe • Different national TTO and VAS values are now available • Possibility to compare values from different countries

  3. First comparisons in 1988 (EQ-6D)

  4. Comparisons in 1999 with (EQ-5D)

  5. TTO-values EQ-5D in 1999

  6. Problem & Hypotheses • German TTO values higher than English and Spanish • Explanation by exclusion • Culture • National nature of the inhabitants • Methods / investigators • Investigators use the same protocol • Sample • Back ground variable do matter • Back ground variables are distributed differently • Effect should disappear if we control for back ground variables • co-variate analysis

  7. Samples differ in background variables • The German sample is older and smarter • But background variables do not explain the differences

  8. Conclusion (so fare) • VAS does not differ • Not cultural determined • TTO differs • Back ground variables do not appear to account for the difference found • TTO could be cultural determined • But… country and investigator are linked • Differences between countries can be differences between investigators • Prove of the pudding…replication within country

  9. Replication of York Study VASMacran S Kind P. Valuing the EQ-5D health states using a modified MVH protocol. Proceedings Plenary Meeting of the EuroQol Group, Sitges, Spain, 6/11/1999.

  10. Replication of York Study TTOMacran S Kind P. Valuing the EQ-5D health states using a modified MVH protocol. Proceedings Plenary Meeting of the EuroQol Group, Sitges, Spain, 6/11/1999.

  11. Conclusion (end) • VAS are not cultural determined • TTO differs • Back ground variables do not account for all difference • TTO are perhaps cultural determined • But differences between countries are also differences between investigators • Different investigators give different values • Little proof that TTO-values differ in Europe • Yes,…. there is room for an European tariff

  12. Euro Tariff

  13. Negative values • Negative values in York protocol are disputed • Little theoretical consensus • Difficult to handle • Compare negative and positive values separately

  14. Positive values

  15. Negative values

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