Results are presented of one of two studies commissioned by TRL into the revaluation of non-fatal casualty costs. The alternative study, (Jones-Lee et al 1993, see IRRD 857398 = C 2857 S)) reports the results of a national sample survey of willingness to pay to reduce the risk of injury. This report discusses the application of the RULA (Relative Uitility Loss Approach) methodology to the valuation of non-fatal injuries and the outcome of a small survey of experts using a variety of existing health state indices to place values on pre-determined road traffic accident injuries. It was decided to evaluate this methodology. The Enviromental Risk Assessment Unit of the University of East Anglia reviewed the literature, (Ives and Kemp 1993, see IRRD 857396), to identify a selection of utility loss indices which might be applied to a pre-determined set of road traffic accident injury descriptions considered to cover the range of injuries classified by the Department of Transport as 'serious'. The injuries selected were common to both studies and were based on work being carried out by TRL on the long term effects of road traffic accident injuries. Four indices were ultimately chosen for the survey, there were: (1) Rosser's Classification of Illness States; (2) Torrance's Health Classification System; (3) Euroqol Descriptive Classification; and (4) The York Health Economics Consortium's revaluation of the Rosser matrix, referred to /R as "Rosser-Revisited". A Visual Analogue rating exercise was also carried out. A questionnaire was developed which asked experts to map profiles of each injury description on to utility loss indices and a Visual Analogue Scale. In addition, a round table meeting was held to explore the views of experts on the mapping exercise and to understand the processes that had influenced their decisions. The advantages and limitations of the RULA methodoloy are discussed and fundamental assumptions concerning the relationship between duration and utility are stated. The methodology for converting utility values into monetary values is described. Values produced from three of the four matrices converged over a similar range, while one matrix produced values that were substantially lower. Reasons for the convergence of three of the scales and divergence of one are suggested and discussed. From the economic point of view there are still some philosophical problems with this approach, there are also limitations in using the existing matrices that were not designed for road traffic accident injuries. Despite this the results of this study are considered to be encouraging.
Samenvatting