Abstract
Researchers have developed various health state measures to capture the value of living well. They have reached a consensus that health state measures focus on functionality and general symptoms. One can assess functionality and general symptoms with or without medical technologies (for example, medication, laser surgery, or a pacemaker), nonhuman aids (for example, glasses or a wheelchair), human assistance (for example, the help of another person), and accommodating environmental factors (for example, a barrier-free physical environment). Researchers have paid little attention to these distinctions. In this paper, I discuss why such distinctions are important and explore what implications they have for the construction and application of health state measures. I use the Health Utilities Index Mark 3 (HUI) and the health state measure in the World Health Survey (WHS) as examples of pioneer measures that explicitly acknowledge different levels of functionality and general symptoms. I conclude that the inclusion of medical technologies and nonhuman aids in the assessment of health is reasonable, but not human assistance or accommodating environmental factors. While this conclusion is in line with the HUI and WHS, I discuss a rationale for this boundary and make further suggestions regarding scoring of health states.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- DALY:
-
Disability-adjusted Life Year
- HALex:
-
Health and Activity Limitation Index
- HIV:
-
human immunodeficiency virus
- HRQOL:
-
health-related quality of life
- HUI:
-
Health Utilities Index
- ICF:
-
International Classification of Functioning, Disability and Health
- WHS:
-
World Health Survey
References
D Feeny W Furlong M Boyle GW Torrance (1995) ArticleTitleMulti-attribute Health Status Classification Systems: Health Utilities Index. PharmacoEconomics 7 490–502
D Feeny W Furlong GW Torrance et al. (2002) ArticleTitleMulti-attribute and single-attribute utility functions for the Health Utilities Index Mark 3 system. Med Care 40 113–128 Occurrence Handle10.1097/00005650-200202000-00006
Health Utilities Group. Health Utilities Index and Quality-of-life. Available at http://www.fhs.mcmaster.ca/hug/, last accessed May 27, 2004.
EuroQol Group. Welcome to the website of the EuroQol Group. Available at http://www.euroqol.org/, last accessed May 27, 2004.
R Brooks (1996) ArticleTitleThe EuroQol Group. EuroQol: The current state of play. Health Policy 37 53–72 Occurrence Handle10.1016/0168-8510(96)00822-6 Occurrence Handle1:STN:280:BymB1c7mt1Q%3D Occurrence Handle10158943
P Erickson R Wilson I Shannon (1995) ArticleTitleYears of health life. Healthy people 2000, Statistical Notes 7 1–14
P Erickson (1998) ArticleTitleEvaluation of a population-based measure of quality of life–the health and activity limitation index (HAlex). Qual Life Res 7 101–114
World Health Organization: World Health Survey Home Page. Available at http://www3.who.int/whs/, last accessed May 27, 2004.
TB Üstün S Chatterji A Mechebal CJL Murray (2003) The World Health Survey. CJL Murray DB Evans (Eds) Health Systems Performance Assessment: Debates, Methods and Empiricism. World Health Organization Geneva 797–808
JA Salomon CD Mathers S Chatterji et al. (2003) Quantifying individual levels of health: Definitions, concepts, and measurement issues. CJL Murray DB Evans (Eds) Health Systems Performance Assessment: Debates, Methods and Empiricism. World Health Organization Geneva 797–808
DG Fryback (1998) Appendix C: Methodological issues in measuring health status and health-related quality of life for population health measures: A brief overview of the ‘HALY’ family of measures. MJ Field MR Gold (Eds) Summarizing Population Health: Directions for the Development and Application of Population Metrics. Institute of Medicine Washington, DC 39–57
InstitutionalAuthorNameWorld Health Organization (2001) International Classification of Functioning, Disability and Health. World Health Organization Geneva
JEJ Ware RH Brook AR Davies KN Lohr (1981) ArticleTitleChoosing measures of health status for individuals in general populations. Am J Public Health 71 620–625
World Health Organization. World Health Survey, short version questionnaire, rotation A. 2000; 2.1–2.2. Available at http://www3.who.int/whs/P/instrumentandrel8293.html, Last accessed May 27, 2004.
JA Salomon A Tandon CJL Murray (2004) ArticleTitleWorld Health Survey Pilot Study Collaborating Group. Comparability of self rated health: Cross sectional multi-country survey using anchoring vignettes. Br Med J 328 258–263
S Anand (2002) ArticleTitleThe concern for equity in health. J Epidemiol Commun Health 56 485–487
MC Nussbaum (2000) Women and Human Development: The Capabilities Approach. Cambridge University Press Cambridge
DD Reidpath PA Allotey A Kouame RA Cummins (2003) ArticleTitleMeasuring health in a vacuum: Examining the disability weight of the DALY. Health Policy Plann 18 351–356
P Allotey D Reidpath A Kouame R Cummins (2003) ArticleTitleThe DALY, context and the determinants of the severity of disease: An exploratory comparison of paraplegia in Australia and Cameroon. Social Sci Med 57 949–958
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Asada, Y. Medical technologies, nonhuman aids, human assistance, and environmental factors in the assessment of health states. Qual Life Res 14, 867–874 (2005). https://doi.org/10.1007/s11136-004-0910-z
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s11136-004-0910-z