Measuring Health Preferences for Health Utilities Index Mark 3 Health States: A Study of Feasibility and Preference Differences among Ethnic Groups in Singapore

Background. Little is known about the health preferences of Southeast Asians. The authors therefore investigated the feasibility of measuring health preferences of Chinese, Malays, and Indians in Singapore and compared their preference scores.

Methods. A stratified random sample of the Singaporean general population was interviewed to measure preferences for a set of health states defined by the Health Utilities Index Mark 3 (HUI3) using both the rating scale (RS) and the standard gamble (SG) methods. Feasibility of preference measurement was assessed using ratings of measurement tasks, task completion rates, and ranking of preference scores. Differences in preference scores across Chinese, Malays, and Indians were examined using analysis of variance models.

Results. Among 245 interviewed respondents (Chinese: 110, Malays: 73, Indians: 62), 97.1% and 95.1% successfully completed all the RS and SG measurement tasks, respectively; 70.1% and 75.3% judged the RS and SG tasks as “easy” or “very easy,” respectively. Interviewers rated 69.4% and 75.0% of these respondents as having “full comprehension” for the RS and SG tasks, respectively; “full concentration” was observed in 84.1% and 84.0% of these respondents for the RS and SG tasks, respectively. There were no significant differences in mean preference scores across Chinese, Malays, and Indians, with and without adjustment for effects of confounding variables.

Conclusions. RS and SG are feasible methods for measuring health preferences for Asians in Singapore; it appears that Chinese, Malays, and Indians in Singapore have similar preferences for HUI3 health states.