scholarly journals Social tariffs and democratic choice – do population-based health state values reflect the will of the people?

2019 ◽  
Author(s):  
Paul Schneider
Keyword(s):  
Quality Of Life ◽  
Future Research ◽  
Economic Evaluations ◽  
Health State ◽  
Health Related Quality ◽  
Health States ◽  
Health Technologies ◽  
Related Quality ◽  
Health Related

In economic evaluations of health technologies, health outcomes are commonly measured in terms of QALYs. QALYs are the product of time and health-related quality of life. Health-related quality of life, in turn, is determined by a social tariff, which is supposed to reflect the public’s preference over health states. This paper argues that, because of the tariff’s role in the societal decision making process, it should not be understood as merely a statistical model, but as a major instrument of democratic participation. I outline what implications this might have for both the method used to aggregate individual preferences, and the set of individuals whose preferences should count. Alternative tariff specifications are explored, and future research directions are proposed.

scholarly journals Developing a preference-based measure for weight-specific health-related quality of life in adolescence: the WAItE UK valuation study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054203
Author(s):  
Tomos Robinson ◽  
Sarah Hill ◽  
Yemi Oluboyede
Keyword(s):  
Quality Of Life ◽  
Economic Evaluation ◽  
Economic Evaluations ◽  
Health Related Quality ◽  
Health States ◽  
Related Quality ◽  
Health Related ◽  
The Uk ◽  
Specific Health

IntroductionAdolescent obesity is a public health problem in the UK. The Weight-Specific Adolescent Instrument for Economic Evaluation (WAItE) has been developed as the first weight-specific health-related quality of life measure appropriate for economic evaluation, but currently cannot be used to generate quality-adjusted life years (QALYs), which are the basis of cost-utility analysis. Generic measures (such as the EQ-5D-Y or CHU-9D) may be insensitive to small but important health changes in overweight or obese adolescents. This study aims to generate a preference-based scoring algorithm for the WAItE.Methods and analysisA discrete choice experiment (DCE) will be administered to value health states described by the WAItE classification system. These health states will be presented to members of the adult general population of the UK via an online survey. A range of regression models will be used to produce the utility algorithm for the WAItE. The DCE-visual analogue scale and time trade-off (TTO) anchoring methods will be used anchor the value set on to the 0–1 QALY scale.Ethics and disseminationThe Newcastle University Medical School Ethics Committee approved the study (references 4772/2020 (DCE) and 9978/2020 (TTO)). The developed algorithm can be applied to future economic evaluations of weight management interventions and treatments for adolescents.

scholarly journals Health-Related Quality of Life in Children with Developmental Disorders

2021 ◽  
Author(s):  
Marina M. Schoemaker ◽  
Suzanne Houwen
Keyword(s):  
Quality Of Life ◽  
Developmental Disorders ◽  
Developmental Coordination Disorder ◽  
Autism Spectrum ◽  
Future Research ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Lower Hrqol

Abstract Purpose of Review (1) To give an overview of what is currently known about health-related quality of life (HRQoL) in three common and co-occurring developmental disorders: attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASD), and developmental coordination disorder (DCD), and (2) to provide directions for future research. Recent Findings HRQoL is compromised in all three developmental disorders, affecting various domains of HRQoL. However, some domains are more affected than others depending on the nature of the core deficits of the disorder. Overall, parents’ rate HRQoL of their children lower than the children themselves. Children with ASD and ADHD with co-occurring disorders have lower HRQoL compared to those with singular disorders. Future studies in DCD are needed to investigate the effect of co-occurring disorder in this population. Summary Children with developmental disorders have lower HRQoL than typically developing children. Future research should focus on the effects of co-occurring disorders on HRQoL and on protective factors that may increase HRQoL. HRQoL should be a part of clinical assessment, as it reveals the areas in life children are struggling with that could be targeted during intervention.

scholarly journals Valuing health-related quality of life among the Indian population: a protocol for the Development of an EQ-5D Value set for India using an Extended design (DEVINE) Study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039517
Author(s):  
Gaurav Jyani ◽  
Shankar Prinja ◽  
Sitanshu Sekhar Kar ◽  
Mayur Trivedi ◽  
Binod Patro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Added Value ◽  
Computer Assisted ◽  
Health Related Quality ◽  
Health States ◽  
Value Set ◽  
Related Quality ◽  
Health Related ◽  
The Government

IntroductionQuality-adjusted life year (QALY) has been recommended by the government as preferred outcome measure for Health Technology Assessment (HTA) in India. As country-specific health-related quality of life tariff values are essential for accurate measurement of QALYs, the government of India has commissioned the present study. The aim of this paper is to describe the methods for the Development of an EQ-5D Value set for India using an Extended design (DEVINE) Study. Additionally, this study aspires to establish if the design of 10-time trade-off (TTO) blocks is enough to generate valid value sets.Methods and analysisA cross-sectional survey using the EuroQol Group’s Valuation Technology (EQ-VT) will be undertaken in a sample of 2700 respondents selected from six different states of India using a multistage stratified random sampling technique. The participants will be interviewed using computer-assisted personal interviewing technique. The TTO valuation will be done using 10 composite TTO (c-TTO) tasks and 7 discrete choice experiment (DCE) tasks. Hybrid modelling approach using both c-TTO and DCE data to estimate the potential value set will be applied. Values of all 3125 health states will be predicted using both the conventional EQ-VT design of 10 blocks of 10 TTO tasks, and an extended design of 18 blocks of 10 TTO tasks. The potential added value of the eight additional blocks in overall validity will be tested. The study will deliver value set for India and assess the adequacy of existing 10-blocks design to be able to correctly predict the values of all 3125 health states.Ethics and disseminationThe ethical approval has been obtained from Institutional Ethics Committee of PGIMER, Chandigarh, India. The anonymised EQ-5D-5L value set will be available for general use and in the HTAs commissioned by India’s central HTA Agency.

Health Outcomes Used to Determine Facets of Health-related Quality of Life for Post-9/11 Veterans Using Assistive Technology for A Combat-related Mobility Impairment: A Literature Review

2021 ◽  
Author(s):  
Mark Greenhalgh ◽  
Hailee Kulich ◽  
Eline Blaauw ◽  
Rose Turner ◽  
Sara Peterson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Outcomes ◽  
Assistive Technology ◽  
Health Related Quality ◽  
Mobility Impairment ◽  
Health States ◽  
Mobility Impairments ◽  
Related Quality ◽  
Health Related

ABSTRACT Introduction Novel rehabilitation methods, including distribution and adoption of assistive technology for lower extremity impairments, are becoming crucial to ensure positive quality of life in all individuals. The quality of life of post-9/11 combat veterans is not well understood, in comparison to research on other populations. The following essay describes a review on health outcomes used to determine health-related quality of life (HR-QoL) among combat-injured service members who require mobility-related assistive technology. Materials and Methods Reviews pooled data from research on PubMed, EMBASE, CINAHL, and PsycINFO published after September 11, 2001, and included service members who sustained a mobility impairment because of involvement in a post-9/11 combat operation. Basic descriptors were extracted in addition to health outcomes used, which were then categorized and summarized by six domains for HR-QoL as defined by the World Health Organization. Results This review found health outcomes that fit in the pain and discomfort, negative emotions, mobility, social relations, access to and quality of healthcare services, and religious/spiritual/personal beliefs subdomains. The categorized results detailed their application to track and model HR-QoL health states in those with mobility impairments using mobility-based assistive technology. Conclusions The research on combat-induced mobility impairments indicates assistive technology improves otherwise poor health states. The results model these domains and subdomains to determine overall HR-QoL and the quality of a healthcare intervention, though additional research is needed as only one study was identified to be experimental in design.

scholarly journals Economic Burden And Health-Related Quality Of Life Of Patients With Cystic Fibrosis In Bulgaria

Folia Medica ◽  
2015 ◽  
Vol 57 (1) ◽  
pp. 56-64 ◽  
Author(s):  
Georgi G. Iskrov ◽  
Rumen S. Stefanov ◽  
Julio López-Bastida ◽  
Renata Linertová ◽  
Juan Oliva-Moreno ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Economic Burden ◽  
Resource Utilisation ◽  
Informal Carer ◽  
Health State ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

AbstractObjective:The aim of this study was to determine the economic burden from a societal perspective and health-related quality of life (HRQOL) of patients with cystic fibrosis (CF) in Bulgaria.Materials and methods:We conducted a cross-sectional study of 33 patients with CF and 17 caregivers from Bulgaria. Data on socio-demographic characteristics, health resource utilisation, informal care, labor productivity losses and HRQOL were collected from questionnaires completed by patients or their caregivers. HRQOL was evaluated with the EuroQol 5-domain (EQ-5D-3L) questionnaire.Results:Median annual costs of CF in Bulgaria were € 24 152 per patient in 2012 as a reference year. Median annual costs for children were found to be significantly higher than those for adults – € 31 945 vs. € 15 714 (p = 0.012). This outcome came from statistically significant differences in costs for main informal carer (p < 0.001) and costs for other informal carers (p = 0.022). As a single cost item, drugs had the biggest monetary impact. Median annual drug costs were € 13 059. Bulgarian CF patients showed low HRQOL results – 50 median VAS score and 0.592 median health utilities. A quarter of patients even rated their health state as worse than death.Conclusion:CF patients from Eastern Europe remain a vulnerable population with risk factors for worse health outcomes. Our study provided a state-of-the art analysis that facilitates the elaboration, adoption and application of targeted public health policies to tackle CF-related problems at national and European level.

scholarly journals DIFFERENTIATION OF HEALTH-RELATED QUALITY OF LIFE OUTCOMES BETWEEN FIVE DISEASE AREAS: RESULTS FROM AN INTERNATIONAL SURVEY OF PATIENTS

2018 ◽  
Vol 34 (5) ◽  
pp. 498-506 ◽  
Author(s):  
Olina Efthymiadou ◽  
Jean Mossman ◽  
Panos Kanavos
Keyword(s):  
Quality Of Life ◽  
Policy Decision ◽  
Future Research ◽  
Common Disease ◽  
Health Related Quality ◽  
Health Policy Decision ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression

Objectives:Health-related quality of life (HRQoL) data generated by generic, preference-based instruments (i.e., EQ-5D) are highly demanded in health policy decision making, because they allow for direct comparisons of HRQoL outcomes between disease areas. We aimed to quantify HRQoL outcomes in breast cancer (BC), rheumatoid arthritis (RA), multiple sclerosis (MS), rare cancers (RC), and rare disease (RD) patients and understand the patterns that differentiate HRQoL outcomes between these disease areas, and more specifically between rare and more common disease population groups.Methods:An international, Web survey of patients measured HRQoL (EQ-5D-5L), self-perceived health (EQ-5D-5L Visual Analogue Scale), and additional QoL dimensions, such as patient disability level.Results:We received 675 completed responses. Average utility loss was 53.5 percent, 32.5 percent, and 33.3 percent for RD, RA, and MS patients, respectively, in contrast to 18.6 percent for BC and RC patients. Statistically significant differences (p < .05) were observed between disease groups in all EQ-5D-5L domain outcomes, apart from that of “Anxiety/Depression.” Severe and/or extreme problems were reported in performing usual activities for RD and RC (34 percent and 13 percent of overall problems reported respectively), mobility for MS (18 percent), pain/discomfort for RA (13 percent), and anxiety/depression for BC (7 percent) patients.Conclusions:We demonstrated significant differences in the dimensions that drive HRQoL outcomes between rare and more common diseases and showcased that the same EQ-5D utility may reflect very different severities depending on the patient population under investigation. Future research should examine whether outcomes in other, critical HRQoL domains not included in generic measures also highlight significant differences across disease areas.

scholarly journals Az informális ellátás mérése és egészség-gazdaságtani értékelése

2017 ◽  
Vol 158 (35) ◽  
pp. 1363-1372
Author(s):  
Zsombor Zrubka
Keyword(s):  
Quality Of Life ◽  
Health Economic ◽  
Informal Care ◽  
Economic Assessment ◽  
Future Research ◽  
Health Related Quality ◽  
Practical Applications ◽  
Related Quality ◽  
Health Related

Abstract: Informal care is non-financed care outside the realm of formal healthcare, which represents an increasing challenge for aging societies. Informal care has frequently been neglected in health economic analyses, while in recent years its coverage has increased considerably in the international scientific literature. This review summarizes the methodology of the health-economic assessment of informal care, including the objective and subjective metrics of caregiver burden, its financial and non-financial valuation and practical applications, with special emphasis on the introduction of care-related quality of life instruments (e.g. Care Related Quality of Life – CarerQoL instrument). Care-related quality of life is a different entity from health-related quality of life, the two cannot be combined, so their joint evaluation requires multi-criteria decision analysis methods. Therefore, it is important to determine the societal preferences of care-related quality of life versus health-related quality of life, and map the relationship of care-related quality of life with time. The local validation of tools measuring care-related quality of life, its more widespread practical application and the analysis of its effect on decision making are also important part of the future research agenda. Orv Hetil. 2017; 158(35): 1363–1372.

scholarly journals Burden of illness of hip fractures in elderly Dutch patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
T. A. Kanters ◽  
C. L. P. van de Ree ◽  
M. A. C. de Jongh ◽  
T. Gosens ◽  
L. Hakkaart-van Roijen
Keyword(s):  
Quality Of Life ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Healthcare Costs ◽  
Burden Of Illness ◽  
Economic Evaluations ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Summary Patients with hip fractures experience reduced health-related quality of life and have a reduced life expectancy. Patients’ utilization of healthcare leads to costs to society. The results of the study can be used in future economic evaluations of treatments for hip fractures. Purpose Hip fractures are associated with high mortality, reduced quality of life, and increased healthcare utilization, leading to an economic burden to society. The purpose of this study is to determine the burden of illness of hip fractures in elderly Dutch patients for specific time periods after surgery. Methods Patients with a hip fracture above the age of 65 were included in the study. In the 1-year period after surgery, patients were asked to complete a set of questionnaires pre-injury (retrospectively), and 1 week, 1 month, 3 months, 6 months and 12 months after surgery. The set of questionnaires included the Euroqol 5D (EQ-5D-3L), the iMTA Medical Consumption Questionnaire (iMCQ) and iMTA Productivity Cost Questionnaire (iPCQ). Health-related quality of life was calculated using Dutch tariffs. Costs were calculated using the methodology described in the Dutch costing manual. Results Approximately 20% of patients with a hip fracture died within 1 year. Health-related quality of life was significantly reduced compared to pre-injury values, and patients did not recover to their pre-injury values within 1 year. Total costs in the first year after injury were €27,573, of which 10% were due to costs of the procedure (€2706). Total follow-up costs (€24,876) were predominantly consisting of healthcare costs. Monthly costs decreased over time. Conclusions Hip fractures lead to a burden to patients, resulting from mortality and health-related quality of life reductions, and to society, due to (healthcare) costs. The results of this study can be used in future economic evaluations.

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