Background: Despite recommendations to use patient preferences for cost-effectiveness analyses and to guide treatment decisions, very little is known about how patients value their health.
Objectives: This study estimated the relative value to patients of physical, mental, and social health when making treatment decisions.
Methods: Data were gathered from 16,689 adult outpatients visiting 46 primary care clinics in managed care organizations in California, Texas, Minnesota, Maryland, and Colorado.
Measures: SF-12 health-related quality of life and patient preferences for their current health status as assessed by standard gamble and time trade-off utility methods.
Results: While physical health contributes substantially to patient preferences (35%-55% of the relative variance explained), patients also place an equally high value on their mental health (29%-42%), and almost one-quarter of the relative contribution is due to social health. The contribution of mental health to preferences is stronger in patients with chronic conditions.
Conclusions: Patient preferences, which should be driving treatment decisions, are strongly related to mental and social health, as well as physical health. Thus, medical practice should strive to balance concerns for all three health domains in making treatment decisions, and health care resources should target medical treatments that improve mental and social health outcomes.
Reprinted with permission from Journal of General Internal Medicine, Vol. 14, No. 6, 1999, pp. 357-363. Copyright © 1999 Society of General Internal Medicine.