Individual utilities are inconsistent with rationing choices: A partial explanation of why Oregon's cost-effectiveness list failed.
OBJECTIVE. To test whether cost-effectiveness analysis and present methods of eliciting health condition "utilities" capture the public's values for health care rationing. DESIGN. Two surveys of economics students. The first survey measured their utilities for three states of health, using either analog scale, standard gamble, or time tradeoff. The second survey measured their preferences, in paired rationing choices of the health states from the first survey and also compared with treatment of acutely fatal appendicitis. The rationing choices each subject faced were individualized according to his or her utility responses, so that the subject should have been indifferent between the two conditions in each rationing choice. RESULTS. The analog-scale elicitation method produced significantly lower utilities than the time-tradeoff and standard-gamble methods for two of the three conditions (p