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Health Policy. 2006 May;76(3):359-70. Epub 2005 Oct 7.

A comparison of individual and social time trade-off values for health states in the general population.

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Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Norrbacka, SE-171 76 Stockholm, Sweden.


This study aimed to compare directly elicited individual time trade-off (TTO) values in a general population sample with the social values derived using the UK EQ-5D index tariff. In the Stockholm County 1998 postal Public Health Survey (n=4950, 20-88 years), the EQ-5D self-classifier, a TTO and a rating scale (RS) question were included (n=2549 for all three questions). The mean TTO (EQ-5D) value was 0.943 (0.890) in the youngest age-group and 0.699 (0.733) in the oldest age-group. The difference between TTO and EQ-5D values was greater in more severe health status groups was. The same equation as for the UK EQ-5D index tariff was estimated for TTO and RS and resulted in significant and consistent coefficients for nearly all dimensions. The coefficients for moderate problems were closer to the EQ-5D index tariff than the coefficients for severe problems. Age was also significant after controlling for the EQ-5D dimensions (p<0.05). The results suggest that individual and social TTO values differ systematically and that the difference is greater the more severe the health status is. The social EQ-5D index tariff may also underestimate the severity in health status at older ages; age appears to correlate with additional health problems not captured by the EQ-5D classification.

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