A CATALOG OF PARENTAL UTILITIES FOR THEIR CHILDREN'S HEALTH

   The objective of this study was to assess parents’ utilities, on behalf of their children, for a wide range of important pediatric health states, using standard gamble (SG) and time trade-off (TTO) methodologies.

   Subjects, recruited through our Pediatric Research Network (PReSNet), were parents or guardians at least 18 years of age, who had at least one child less than 18 years of age.  Recruitment locations included pediatric clinics, the Indiana State Fair, and public and private conventions.  Trained research assistants interviewed participants using a computer-assisted script.  Each subject’s utilities were assessed for three random health states out of twenty-nine that we had chosen for study.  Both the TTO and SG methods were used to measure utilities, and the methods were applied in random order.  In the SG, the utility of the lowest ranked health state was compared to a gamble between good health and death.  To minimize the “death effect” subsequent health states were compared to a gamble between good health and the next worst health state (“laddering”).  For families with more than one child, we assessed the utilities with respect to one randomly selected child.

   Of 4,497 parents approached, 3955 (88%) completed the survey.  Mothers constituted 85% and 13% were fathers.  Parents’ race was 48% African American and 47% white.  There was a good distribution of income and education status among participants.  Utilities ranged from a high for acute otitis media (0.97 SG, 0.96 TTO) to a low for severe mental retardation (0.59 SG, 0.51 TTO).  Fewer than 15% of respondents provided SG utilities that were inconsistent with their TTO preference order.  With the exception of severe mental retardation, mean SG and TTO utilities were not significantly different, differing by less than 4 utiles.

   We have assembled a catalog of utilities for important pediatric health states that has face validity and internal consistency.  It should be invaluable for cost-utility analyses and decision analyses for pediatric patients.