Exploring a Markov Model Framework to Quantify Societal Preferences, Concerning Age and Severity of Disease, for Health Resource Allocation

Abstract

Certain health problems are considered as a normal part of ageing, hence are more acceptable at older, rather than at younger ages. In the context of this research, acceptability has been defined as the proportion of the general population who consider a certain health state acceptable for a given age. We propose a Markov model framework to quantify societal preferences concerning the severity of the health state and age of the affected individuals. Health states in each model cycle are split to acceptable and not acceptable proportions, with different priority weights. Health gains originated from the shifts between health states, are expressed in Quality Adjusted Life Years (QALYs). Using the Hungarian acceptability set and value set of the EQ-5D-3L health status measurement tool, we compare health gains in four priority function scenarios with and without adjustment for acceptability. The analysis on selected health states suggested, that priority scenarios valuing both time in acceptable health and health gains in not acceptable health, reflect several societal preferences, related to healthcare resource allocation. However, more theoretical and empirical research is needed before this method can be implemented in real- life decision-making.