The effect of duration and time preference on the gap between adult and child health state valuations in time trade-off

Zhongyu Lang*, Arthur E. Attema, Stefan A. Lipman

*Corresponding author for this work

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3 Citations (Scopus)
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Composite time trade-off (cTTO) utilities have been found to be higher when adults value health states for children than for themselves. It is not clear if these differences reflect adults assigning truly higher utilities to the same health state in different perspectives, or if they are caused by other factors, which are not accounted for in the valuation procedure. We test if the difference between children’s and adults’ cTTO valuations changes if a longer duration than the standard 10 years is used. Personal interviews with a representative sample of 151 adults in the UK were conducted. We employed the cTTO method to estimate utilities of four different health states, where adults considered states both from their own and a 10-year-old child’s perspective, for durations of 10 and 20 years. We corrected the cTTO valuations for perspective-specific time preferences in a separate task, again for both perspectives. We replicate the finding that cTTO utilities are higher for the child perspective than for the adult perspective, although the difference is only significant when controlling for other variables in a mixed effects regression. Time preferences are close to 0 on average, and smaller for children than adults. After correcting TTO utilities for time preferences, the effect of perspective is no longer significant. No differences were found for cTTO tasks completed with a 10- or 20-year duration. Our results suggest that the child–adult gap is partially related to differences in time preferences and, hence, that correcting cTTO utilities for these preferences could be useful.

Original languageEnglish
Number of pages13
JournalEuropean Journal of Health Economics
Publication statusPublished - 8 Jul 2023

Bibliographical note

Funding Information:
This research was made possible through a grant from The EuroQol Group, project number EQ Project 237-RA. The views expressed in this paper are those of the authors and do not necessarily reflect the views of The EuroQol Group. We are grateful to Matthijs Versteegh for advice in developing the study. Dr. Lipman is also co-funded by Smarter Choices for Better Health Initiative. The authors declare to have no conflicts of interest. Data are available from the authors upon reasonable request.

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Publisher Copyright:
© 2023, The Author(s).


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