INTRODUCTION: Published literature reveals contradicting evidence when comparing VAS valuations for child and adult health states (HS). In contrast, studies using a TTO- or DCE-based methodology consistently resulted in higher utilities for children.

AIM: To explore VAS valuation for child and adult HS, and to investigate the impact of parenting experience on HS valuations. Furthermore, to understand which viewpoint respondents take when valuing child HS.

METHODS: Members of the general public (UK, Belgium and The Netherlands) were invited to value four HS from two perspectives (8-year-old child, 40-year-old adult) using the VAS. The shift in VAS related to perspective was estimated with a generalized linear model. The HS were: mild (12211), moderate (22222), severe (23332), worst (33333).

RESULTS: Global statistical testing showed a mean difference of 2.9 for child versus adult VAS values (p<0.01). This difference increased with the severity of the HS: the VAS was not different between children and adults for the mild (76.4 vs. 75.0) and moderate (54.4 vs. 52.8) health states, but significant differences were found for the severe (31.7 vs. 28.0, p=0.05) and the worst (14.9 vs. 9.8, p=0.001) HS.

Parents (58%) valued child health states significantly higher than respondents without children (42%), across all health states. Parents also valued HS significantly higher when they related to children compared to adults, whereas respondents without children did not value the child or adult health states any differently.

When valuing child HS, 79% of respondents were making a judgement about what would be best for the child; 36% were thinking about what the child would prefer, and 31% were thinking what they would prefer as a child.

CONCLUSION: In this study, some evidence was found that severe HS are valued higher for children than for adults, and also that parents rank child HS higher using the VAS.