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Purpose <p>Healthcare decision-making often assumes equal value for quality-adjusted life years (QALYs) across patient groups, yet societal preferences suggest that the value of a QALY may vary with characteristics such as age. Evidence indicates some willingness to prioritise child health gains, though findings are inconsistent. This study used person trade-off (PTO) to estimate the relative social value of different types of health gains for children and adolescents (aged 0–24&#xa0;years) compared with adults.</p> Methods <p>A representative Australian sample aged 16&#xa0;years and above (<i>n</i>&#xa0;=&#xa0;2098) completed an online survey comparing life extension and quality-of-life improvements for different ages. A ‘chaining’ approach tested response consistency, and logistic regression explored associations between PTO choices and respondent characteristics. Attitudinal questions and open text responses provided additional insights.</p> Results <p>PTO responses show that health gains for children and adolescents (4–24&#xa0;years) are generally valued more highly than those for adults (age 40 or 55&#xa0;years), with weights ranging from 1 to 1.3. For very young children, findings vary by health gain type: life extensions for infants (1&#xa0;month or 2&#xa0;years) are weighted lower, but pain alleviation is higher (weights ≥&#xa0;1.2). Qualitative and attitudinal data reveal diverse views, with many opposing age-weighting. Younger respondents and those with young children prioritise children more, while older and female participants preferred equal treatment.</p> Conclusions <p>The relative value of child QALY gains varies by age of the child, by health gain type, and by adult comparison age. While alleviating children’s pain is strongly supported (weights ≥&#xa0;1.2), overall views are polarised, highlighting the complexity of age-based prioritisation.</p>

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Are Health Gains to Children and Adolescents More Important Than Health Gains to Adults? A Person Trade-Off Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月7日

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  • Tessa Peasgood,
  • Udeni De Silva Perera,
  • Gang Chen,
  • Cate Bailey,
  • Richard Norman,
  • Rosalie Viney,
  • Koonal Shah,
  • Nancy Devlin

摘要

Purpose

Healthcare decision-making often assumes equal value for quality-adjusted life years (QALYs) across patient groups, yet societal preferences suggest that the value of a QALY may vary with characteristics such as age. Evidence indicates some willingness to prioritise child health gains, though findings are inconsistent. This study used person trade-off (PTO) to estimate the relative social value of different types of health gains for children and adolescents (aged 0–24 years) compared with adults.

Methods

A representative Australian sample aged 16 years and above (n = 2098) completed an online survey comparing life extension and quality-of-life improvements for different ages. A ‘chaining’ approach tested response consistency, and logistic regression explored associations between PTO choices and respondent characteristics. Attitudinal questions and open text responses provided additional insights.

Results

PTO responses show that health gains for children and adolescents (4–24 years) are generally valued more highly than those for adults (age 40 or 55 years), with weights ranging from 1 to 1.3. For very young children, findings vary by health gain type: life extensions for infants (1 month or 2 years) are weighted lower, but pain alleviation is higher (weights ≥ 1.2). Qualitative and attitudinal data reveal diverse views, with many opposing age-weighting. Younger respondents and those with young children prioritise children more, while older and female participants preferred equal treatment.

Conclusions

The relative value of child QALY gains varies by age of the child, by health gain type, and by adult comparison age. While alleviating children’s pain is strongly supported (weights ≥ 1.2), overall views are polarised, highlighting the complexity of age-based prioritisation.