An exploration of Maori health state preferences

Abstract

The allocation of publicly funded resources in the health sector via Cost Utility Analysis requires preferences for different health states to be known. While preferences for New Zealanders as a whole have been elicited, the possibility of different preferences among Maori remain. This research explores this possibility as well as looking at what Maori perceive as health and draws conclusions from these findings relating to priority setting and resource allocation in the health sector. Using the EQ-5D (a generic health state classification system) and a Visual Analogue Scale (VAS) preferences were elicited for a sample of 64 Maori from three main groups in a face-to-face interview style setting. An additional five participants were involved in a post questionnaire interview to try and gain greater understanding of the process involved in the questionnaire completion. Data from participants was scaled according to conventional procedures with full health and "dead" anchored at 1 and 0 respectively and other valuations interpolated and extrapolated appropriately. Statistical tests comparing the mean values of each health state from the current sample to both Maori and non-Maori from a New Zealand wide postal survey were then undertaken. The health state preferences for the Maori group were found to be very similar to both the Maori and non-Maori from the previous research. Unfortunately the vast majority of participants neglected to place the health state "dead" on the VAS meaning that their valuations were unable to be scaled and included in the majority of the analysis. Qualitative data from both the questionnaire and the interviews suggest that there is more to health than as described in the questionnaire but this is not Maori specific and related equally to non-Maori, The lack of difference in preferences implies that it does not matter whose valuations are used in priority setting as the end result will be the same. Further research would be beneficial to investigate why the state "dead" was omitted from being valued. Also, a larger sample of Maori would be useful to provide stronger conclusions than the limited ones drawn here as a result of the low number of participants valuing "dead".