The Value Adults Place on Child Health and Functional Status

Objectives: To summarize the value adults place on child health and functional status and provide a new quantitative tool that enhances our understanding of the benefits of new health technologies and illustrates the potential contributions of existing data sets for comparative effectiveness research in pediatrics. Methods: Respondents, ages 18 years and older, were recruited from a nationally representative panel between August 2012 and February 2013 to complete an online survey. The survey included a series of paired comparisons that asked respondents to choose between child health and functional status outcomes, which were described using the National Survey of Children with Special Health Care Needs, a 14-item descriptive system of child health outcomes. Using respondent choices regarding an unnamed 7- or 10-year-old child, generalized linear model analyses estimated the value of child health and functional status on a quality-adjusted life-year scale. Results: Across the domains of health and functional status, repeated or chronic physical pain, feeling anxious or depressed, and behavioral problems (such as acting out, fighting, bullying, or arguing) were most valuable, as indicated by adult respondents' preference of other health problems to avoid outcomes along these domains. Discussion: These findings may inform comparative effectiveness research, health technology assessments, clinical practice guidelines, and public resource allocation decisions by enhancing understanding of the value adults place on the health and functional status of children. Conclusions: Improved measurement of public priorities can promote national child health by drawing attention to what adults value most and complementing conventional measures of public health surveillance.