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


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.

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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). 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.

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Correspondence to Milad Karimi.

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Karimi, M., Brazier, J. Health, Health-Related Quality of Life, and Quality of Life: What is the Difference?. PharmacoEconomics 34, 645–649 (2016).

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  • Life Satisfaction
  • HRQoL Measure
  • Personal Wellbeing Index
  • HRQoL Questionnaire
  • Health Status Questionnaire