The association between the value of a statistical life and frailty in Burkina Faso

Leila Freidoony, Dina Goodman-Palmer, Fred Barker, Mamdou Bountogo, Pascal Geldsetzer, Guy Harling, Lisa R HIrschhorn, Jennifer Manne-Goehler, Mark J Siedner, Stefan T Trautmann, Yilong Xu, Miles Witham, Justine Davies
{"title":"The association between the value of a statistical life and frailty in Burkina Faso","authors":"Leila Freidoony, Dina Goodman-Palmer, Fred Barker, Mamdou Bountogo, Pascal Geldsetzer, Guy Harling, Lisa R HIrschhorn, Jennifer Manne-Goehler, Mark J Siedner, Stefan T Trautmann, Yilong Xu, Miles Witham, Justine Davies","doi":"10.1101/2024.02.10.24302634","DOIUrl":null,"url":null,"abstract":"Background: To ensure resources invested into services are commensurate with benefit, economists utilise various methods to assess value of life. Understanding the performance of these methods in older populations is crucial, particularly in low-and-middle-income countries (LMICs), where the majority of older people will live by 2030. Value of Statistical Life Years (VSLY) is widely used in cost-benefit analyses but rarely been in LMICs or in older people. Objective: This study aimed to investigate the hypothesis that frailty would be associated with a lower VSLY in participants in rural Burkina Faso, when controlling for factors found in other studies likely to affect VSLY, such as socio-demographics, multimorbidity, quality of life, and disability.\nMethods: The study included 3,988 adults aged 40 years and older from a population-representative household survey done in Nouna, Burkina Faso. Data were collected on sociodemographic characteristics, chronic medical conditions, quality of life, disability, physical performance, and VSLY. Frailty status was derived using Fried's frailty phenotype. Bivariate analyses investigated the association between quintiles of VSLY and frailty. To explore modification of associations by other variables, we built sequential binary logistic regression models comparing each quintile of VSLY with the first (lowest) quintile. Models included frailty category, age, sex, marital status, educational attainment, and wealth. We sequentially added quality of life, multimorbidity, and disability.\nResults: Of 2,761 survey participants included in this analysis, 51.4% were female. Average age was 54.5 years (with 70.0% aged 40-59 years), 24.8% of respondents reported being alone, and 84.5% had not completed education. In bivariate analyses, we found a significant negative association between higher VSLY and frailty, increasing age, disability, and quality of life. Conversely, being male, married, and educated were positively associated with higher VSLY. The negative association between VSLY and frailty remained significant after adjusting for age, gender, education, wealth, quality of life, disability, and multimorbidity (odds of being frail for VSLY quintile 5 vs quintile 1 was 0.48, 95% CI 0.37-0.64 for the fully adjusted model). Furthermore, effect of age, education, and wealth on VSLY became non-significant once frailty was included in the model.\nConclusion: There is a strong relationship between the value that older people place on their lives and their frailty status. Frailty status is important to consider when assessing VSLY, especially in LMICs in which there is a rapidly growing older population.","PeriodicalId":501072,"journal":{"name":"medRxiv - Health Economics","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"medRxiv - Health Economics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1101/2024.02.10.24302634","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: To ensure resources invested into services are commensurate with benefit, economists utilise various methods to assess value of life. Understanding the performance of these methods in older populations is crucial, particularly in low-and-middle-income countries (LMICs), where the majority of older people will live by 2030. Value of Statistical Life Years (VSLY) is widely used in cost-benefit analyses but rarely been in LMICs or in older people. Objective: This study aimed to investigate the hypothesis that frailty would be associated with a lower VSLY in participants in rural Burkina Faso, when controlling for factors found in other studies likely to affect VSLY, such as socio-demographics, multimorbidity, quality of life, and disability. Methods: The study included 3,988 adults aged 40 years and older from a population-representative household survey done in Nouna, Burkina Faso. Data were collected on sociodemographic characteristics, chronic medical conditions, quality of life, disability, physical performance, and VSLY. Frailty status was derived using Fried's frailty phenotype. Bivariate analyses investigated the association between quintiles of VSLY and frailty. To explore modification of associations by other variables, we built sequential binary logistic regression models comparing each quintile of VSLY with the first (lowest) quintile. Models included frailty category, age, sex, marital status, educational attainment, and wealth. We sequentially added quality of life, multimorbidity, and disability. Results: Of 2,761 survey participants included in this analysis, 51.4% were female. Average age was 54.5 years (with 70.0% aged 40-59 years), 24.8% of respondents reported being alone, and 84.5% had not completed education. In bivariate analyses, we found a significant negative association between higher VSLY and frailty, increasing age, disability, and quality of life. Conversely, being male, married, and educated were positively associated with higher VSLY. The negative association between VSLY and frailty remained significant after adjusting for age, gender, education, wealth, quality of life, disability, and multimorbidity (odds of being frail for VSLY quintile 5 vs quintile 1 was 0.48, 95% CI 0.37-0.64 for the fully adjusted model). Furthermore, effect of age, education, and wealth on VSLY became non-significant once frailty was included in the model. Conclusion: There is a strong relationship between the value that older people place on their lives and their frailty status. Frailty status is important to consider when assessing VSLY, especially in LMICs in which there is a rapidly growing older population.
布基纳法索统计寿命价值与体弱之间的关系
背景:为确保投入服务的资源与收益相称,经济学家利用各种方法评估生命价值。了解这些方法在老年人口中的表现至关重要,尤其是在中低收入国家(LMICs),因为到 2030 年,大多数老年人将生活在这些国家。统计寿命年值 (VSLY) 被广泛用于成本效益分析,但很少用于中低收入国家或老年人。研究目的本研究旨在探讨一个假设,即在控制其他研究中发现的可能影响统计寿命年值的因素(如社会人口学、多病症、生活质量和残疾)的情况下,虚弱与布基纳法索农村参与者较低的统计寿命年值相关:研究对象包括布基纳法索努纳一项具有人口代表性的家庭调查中的 3,988 名 40 岁及以上的成年人。研究收集了有关社会人口特征、慢性疾病、生活质量、残疾、体能表现和 VSLY 的数据。虚弱状态是根据弗里德的虚弱表型得出的。双变量分析调查了 VSLY 五分位数与虚弱之间的关系。为了探讨其他变量对相关性的影响,我们建立了连续的二元逻辑回归模型,将 VSLY 的每个五分位数与第一个(最低的)五分位数进行比较。模型包括虚弱类别、年龄、性别、婚姻状况、教育程度和财富。我们依次加入了生活质量、多病症和残疾:在参与本次分析的 2,761 名调查参与者中,51.4% 为女性。平均年龄为 54.5 岁(70.0% 的受访者年龄在 40-59 岁之间),24.8% 的受访者表示自己独居,84.5% 的受访者未完成学业。在双变量分析中,我们发现较高的 VSLY 与虚弱、年龄增加、残疾和生活质量之间存在显著的负相关。相反,男性、已婚和受过教育与较高的 VSLY 呈正相关。在对年龄、性别、教育程度、财富、生活质量、残疾和多病情况进行调整后,VSLY 与虚弱之间的负相关仍然显著(在完全调整模型中,VSLY 五分位数 5 与五分位数 1 的虚弱几率为 0.48,95% CI 为 0.37-0.64)。此外,将体弱纳入模型后,年龄、教育程度和财富对 VSLY 的影响变得不显著:结论:老年人对其生命的重视程度与其体弱状况之间存在密切关系。在评估 VSLY 时,体弱状况是必须考虑的因素,尤其是在老年人口快速增长的低收入和中等收入国家。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信