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People in states worse than dead according to the EQ-5D UK value set: would they rather be dead?
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
2018 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 27, no 7, p. 1827-1833Article in journal (Refereed) Published
Abstract [en]

Quality-adjusted life years (QALYs) measure health by combining length and quality of life. QALYs constitute the effect side of incremental cost-effectiveness ratios, describing the results of health economic evaluations. The objectives of this study were to (1) investigate the prevalence of states worse than dead (SWD) when using the EuroQol-5D UK value set, and (2) to study to what extent SWDs are reasonable with a starting point in experience-based valuations of health states. Data from a Swedish cross-sectional population survey were used. The survey was directed to 10,000 persons 65 years and older and its primary aim was to investigate the prevalence and consequences of chronic pain. The survey included questions reflecting life situation and well-being. Some of these were used in order to characterise people in SWD. SWD were found in 1.8% of the 6611 respondents. The prevalence of SWD increased with advancing age and was more common among women than men. The control questions used indicated that most of the persons being in SWD according to the EQ-5D UK value set most probably would not judge themselves to be in a SWD. Though negative QALY-weights are not very common, they constitute a non-negligible part of health states in a Swedish population 65 years and older. Prevalence of SWD is higher among women than men and increases with age. From responses to other questions on well-being and life situation, there is reason to doubt the reasonableness of experience-based negative QALY-weights in many cases.

Place, publisher, year, edition, pages
SPRINGER , 2018. Vol. 27, no 7, p. 1827-1833
Keywords [en]
Patient-reported outcomes; Quality-adjusted life years; Life satisfaction; EQ-5D; Health state valuation; States worse than dead
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-149471DOI: 10.1007/s11136-018-1848-xISI: 000435128700014PubMedID: 29616427OAI: oai:DiVA.org:liu-149471DiVA, id: diva2:1231082
Note

Funding Agencies|Grunenthal Sweden AB

Available from: 2018-07-05 Created: 2018-07-05 Last updated: 2018-07-05

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Bernfort, LarsGerdle, BjörnHusberg, MagnusLevin, Lars-Åke
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Division of Health Care AnalysisFaculty of Medicine and Health SciencesDivision of Community MedicinePain and Rehabilitation Center
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