OP267 Evidence for Health Technology Assessment: The Capability Approach

Abstract

Introduction

Healthcare services, such as cochlear implants and subsequent rehabilitation, aim to increase valuable activities and opportunities of those affected. Their impact may be inferred from the extent that they protect or restore capability, which reflects the real freedoms that people have to be or do things they have reason to value. Capability emerges from the dynamic interaction between available resources, individual, social, and environmental conversion factors, and functionings. This model sets the informational requirements of the capability approach.

Methods

On the basis of interviews with thirty-three hearing impaired children and thirty hearing peers, information on capability elements (values, resources, conversion factors, and functionings) was collected. Qualitative results were triangulated with standardized clinical audiological and psycholinguistic quantitative measures.

Results

Hearing impaired children and their hearing peers concurred in terms of the doings and beings they valued, but differed in terms of conversion factors to realize capability. Parents of hearing impaired children played a more upfront role, hearing impairment predominated many areas of life, and communicating through hearing aids required more energy than was usually acknowledged by the people around them.

Conclusions

The capability approach offers opportunities not only to assess impact of technology on dimensions that are important to patients, but also to better understand the mechanisms that are involved in value generation.