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PharmacoEconomics

, Volume 34, Issue 7, pp 645–649 | Cite as

Health, Health-Related Quality of Life, and Quality of Life: What is the Difference?

  • Milad Karimi
  • John Brazier
Current Opinion

Abstract

The terms health, health-related quality of life (HRQoL), and quality of life (QoL) are used interchangeably. Given that these are three key terms in the literature, their appropriate and clear use is important. This paper reviews the history and definitions of the terms and considers how they have been used. It is argued that the definitions of HRQoL in the literature are problematic because some definitions fail to distinguish between HRQoL and health or between HRQoL and QoL. Many so-called HRQoL questionnaires actually measure self-perceived health status and the use of the phrase QoL is unjustified. It is concluded that the concept of HRQoL as used now is confusing. A potential solution is to define HRQoL as the way health is empirically estimated to affect QoL or use the term to only signify the utility associated with a health state.

Keywords

Life Satisfaction HRQoL Measure Personal Wellbeing Index HRQoL Questionnaire Health Status Questionnaire 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

JB proposed initial ideas and paper structure, MK wrote the first and the revised drafts after discussion with JB. JB made comments and revisions on all drafts. Both JB and MK responded to comments from referees.

Professor John Brazier was supported in the preparation/submission of this paper by the HEOM Theme of the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH). http://www.clahrc-yh.nir.ac.uk. The views and opinions expressed are those of the authors, and not necessarily those of the NHS, the NIHR or the Department of Health. JB and MK declare no conflicts of interest.

References

  1. 1.
    Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMedGoogle Scholar
  2. 2.
    Cunillera O, Tresserras R, Rajmil L, Vilagut G, Brugulat P, Herdman M, et al. Discriminative capacity of the EQ-5D, SF-6D, and SF-12 as measures of health status in population health survey. Qual Life Res. 2010;19:853–64.CrossRefPubMedGoogle Scholar
  3. 3.
    Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002;21:271–92.CrossRefPubMedGoogle Scholar
  4. 4.
    Makai P, Brouwer WBF, Koopmanschap MA, Stolk EA, Nieboer AP. Quality of life instruments for economic evaluations in health and social care for older people: a systematic review. Soc Sci Med. 2014;102:83–93.CrossRefPubMedGoogle Scholar
  5. 5.
    Hill MR, Noonan VK, Sakakibara BM, Miller WC. Quality of life instruments and definitions in individuals with spinal cord injury: a systematic review. Spinal Cord. 2010;48:438–50.CrossRefPubMedGoogle Scholar
  6. 6.
    Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. J Am Soc Nephrol. 2001;12:2797–806.PubMedGoogle Scholar
  7. 7.
    Schrag A. The EQ-5D—a generic quality of life measure—is a useful instrument to measure quality of life in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2000;69:67–73.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Elkinton JR. Medicine and the quality of life. Ann Intern Med. 1966;64:711–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Spitzer WO. State of science 1986: quality of life and functional status as target variables for research. J Chronic Dis. 1987;40:465–71.CrossRefPubMedGoogle Scholar
  10. 10.
    Kaplan RM, Bush JW. Health-related quality of life measurement for evaluation research and policy analysis. Health Psychol. 1982;1:61–80.CrossRefGoogle Scholar
  11. 11.
    Bergner M. Measurement of health status. Med Care. 1985;23:696–704.CrossRefPubMedGoogle Scholar
  12. 12.
    Ware JE. The status of health assessment 1994. Annu Rev Public Health. 1995;16:327–54.CrossRefPubMedGoogle Scholar
  13. 13.
    Wenger NK, Mattson ME, Furberg CD, Elinson J. Assessment of quality of life in clinical trials of cardiovascular therapies. Am J Cardiol. 1984;54:908–13.CrossRefPubMedGoogle Scholar
  14. 14.
    Fanshel S, Bush JW. A health-status index and its application to health-services outcomes. Oper Res. 1970;18:1021–66.CrossRefGoogle Scholar
  15. 15.
    Torrance GW. Utility approach to measuring health-related quality of life. J Chronic Dis. 1987;40(6):593–600.CrossRefPubMedGoogle Scholar
  16. 16.
    World Health Organization. Constitution of the World Health Organization. 48th ed. Geneva: Basic documents of the World Health Organization; 2014.Google Scholar
  17. 17.
    Ware JE, Gandek B. The SF-36 Health Survey: development and use in mental health research and the IQOLA Project. Int J Ment Health. 1994;23:49–73.CrossRefGoogle Scholar
  18. 18.
    Brooks R. The EuroQol group after 25 years. Rotterdam: Springer, Netherlands; 2013.CrossRefGoogle Scholar
  19. 19.
    Patrick DL, Bush JW, Chen MM. Toward an operational definition of health. J Health Soc Behav. 1982;14:6–23.CrossRefGoogle Scholar
  20. 20.
    Brazier J, Connell J, Papaioannou D, Mukuria C, Mulhern B, Peasgood T, et al. A systematic review, psychometric analysis and qualitative assessment of generic preference-based measures of health in mental health populations and the estimation of mapping functions from widely used specific measures. Health Technol Assess. 2014;18:1–188.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Moons P, Budts W, De Geest S. Critique on the conceptualisation of quality of life: a review and evaluation of different conceptual approaches. Int J Nurs Stud. 2006;43:891–901.CrossRefPubMedGoogle Scholar
  22. 22.
    Ferrans CE. Quality of life: conceptual issues. Semin Oncol Nurs. 1990;6:248–54.CrossRefPubMedGoogle Scholar
  23. 23.
    Bowling A. Measuring health. Third. Maidenhead: Open University Press; 2005.Google Scholar
  24. 24.
    Peasgood T, Brazier J, Mukuria C, Rowen D. A conceptual comparison of well-being measures used in the UK. Policy Research Unit in Economic Evaluation of Health and Care Interventions. Universities of Sheffield and York. EEPRU Research Report 026. Policy paper/document 01/09/2014. 2014.Google Scholar
  25. 25.
    Rejeski WJ, Mihalko SL. Physical activity and quality of life in older adults. J Gerontol Ser A Biol Sci Med Sci. 2001;56A(Special Issue II):23–35.CrossRefGoogle Scholar
  26. 26.
    Kuyken W, Group TW. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41:1403–9.CrossRefGoogle Scholar
  27. 27.
    Cummins RA. Moving from the quality of life concept to a theory. J Intellect Disabil Res. 2005;49:699–706.CrossRefPubMedGoogle Scholar
  28. 28.
    Felce D, Perry J. Quality of life: its definition and measurement. Res Dev Disabil. 1995;16:51–74.CrossRefPubMedGoogle Scholar
  29. 29.
    Meeberg GA. Quality of life: a concept analysis. J Adv Nurs. 1993;18:32–8.CrossRefPubMedGoogle Scholar
  30. 30.
    Bowling A, Brazier J. Introduction. Soc Sci Med. 1995;41:1337–8.CrossRefGoogle Scholar
  31. 31.
    Hays RD, Reeve BB. Measurement and modeling of health-related quality of life. In: Killewo J, Heggenhougen HK, Quah SR, editors. Epidemiology and demography in public health. San Diego: Academic Press; 2010. p. 195–205.Google Scholar
  32. 32.
    Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA J Am Med Assoc. 1995;273:59–65.CrossRefGoogle Scholar
  33. 33.
    Ebrahim S. Clinical and public health perspectives and applications of health-related quality of life measurement. Soc Sci Med. 1995;41:1383–94.CrossRefPubMedGoogle Scholar
  34. 34.
    Gold MR, Patrick DL, Torrance GW, Fryback D, Hadorn DC, Kamlet M, et al. Identifying and valuing outcomes. In: Gold MR, Siegel JE, Russell LB, Weinstein MC, editors. Cost-effectiveness in health and medicine. Oxford: Oxford University Press; 1996.Google Scholar
  35. 35.
    Bergner M. Quality of life, health status, and clinical research. Med Care. 1989;27:S148–56.CrossRefPubMedGoogle Scholar
  36. 36.
    Moons P. Why call it health-related quality of life when you mean perceived health status? Eur J Cardiovasc Nurs. 2004;3:275–7.CrossRefPubMedGoogle Scholar
  37. 37.
    Leplège A, Hunt S. The problem of quality of life in medicine. J Am Med Assoc. 1997;278:47–50.CrossRefGoogle Scholar
  38. 38.
    Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993;118:622–9.CrossRefPubMedGoogle Scholar
  39. 39.
    Michalos A. Social indicators research and health-related quality of life research. Soc Indic Res. 2004;65:27–72.CrossRefGoogle Scholar
  40. 40.
    Baker R, Robinson A. Responses to standard gambles: are preferences “well constructed”? Health Econ. 2004;13:37–48.CrossRefPubMedGoogle Scholar
  41. 41.
    Nord E, Arnesen T, Menzel P, Pinto JL. Towards a more restricted use of the term “Quality of Life.” Qual Life Newsl. 2001;26:3–4.Google Scholar
  42. 42.
    Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337–43.CrossRefPubMedGoogle Scholar
  43. 43.
    Lau ALD, Cummins RA, McPherson W. An investigation into the cross-cultural equivalence of the Personal Wellbeing Index. Soc Indic Res. 2005;72:403–30.CrossRefGoogle Scholar
  44. 44.
    Brazier J, Ratcliffe J, Salomon JA, Tsuchiya A. Measuring and valuing health benefits for economic evaluation. Oxford: Oxford University Press; 2007.Google Scholar
  45. 45.
    Guyatt G, Feeny D, Patrick D. Postscript. Control Clin Trials. 1991;12:266S–9S.CrossRefGoogle Scholar
  46. 46.
    Gill TM, Feinstein AR. A critical appraisal of the quality of quality-of-life measurements. J Am Med Assoc. 1994;272:619–26.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.School of Health and Related ResearchUniversity of SheffieldSheffieldUK

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