Résumé :
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[BDSP. Notice produite par INIST zZR0xD0Y. Diffusion soumise à autorisation]. Context. - Health values (utilities or preferences for health states) are often incorporated into clinical decisions and health care policy when issues of quality vs length of life arise, but little is known about health values of the very old. Objectlve. To assess health values of older hospitalized patients, compare their values with those of their surrogate decision makers, investigate possible determinants of health values, and determine whether health values change over time. Design. - A prospective, longitudinal, multicenter cohort study. Setting. - Four academic medical centers. Participants. - Four hundred fourteen hospitalized patients aged 80 years or older and their surrogate decision makers who were interviewed and understood the task. Main Outcome Measures. - Time-trade-off utilities, reflecting preferences for current health relative to a shorter but healthy life. Results-On average, patients equated living 1 year in their current state of health with living 9.7 months in excellent health (mean [SD] utility, 0.81 [0.28]). Although only 126 patients (30.7%) rated their current quality of life as excellent or very good, 284 (68.6%) were willing to give up at most 1 month of 12 in exchange for excellent health (utility 0.92). At the other extreme, 25 (6.0%) were willing to live 2 weeks or less in excellent health rather than 1 year in their current state of health (utility 0.04). (...)
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