IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v9y1989i2p142-149.html
   My bibliography  Save this article

Quality-adjusted Life Years, Utility Theory, and Healthy-years Equivalents

Author

Listed:
  • Abraham Mehrez
  • Amiram Gafni

Abstract

Decisions about medical treatments and the settings of health programs are not purely technical, but also involve issues of value such as the evaluation of trade-offs between quality of life (morbidity) and quantity of life (mortality). The most commonly used measure of outcome in such cases is the quality-adjusted life year (QALY). The authors show that QALYs, being a health status index, do not stem directly from the individual's utility function and thus only partly reflect the individual's true preferences. This might lead to the choice of the nonpreferred alternative due to the misrepresentation of the individual's preferences. Two examples illustrate this claim. An alternative measure of outcome, the healthy-years equiv alent (HYE), is described. This measure stems directly from the individual's utility function and thus fully reflects his/her preferences. It combines outcomes of both morbidity and mortality and thus can serve as common unit of measure for all programs, allowing com parisons across programs. Different ways of measuring the HYE are discussed. Key words: utility theory; economic evaluation; cost-effectiveness analysis. (Med Decis Making 1989;9:142-149)

Suggested Citation

  • Abraham Mehrez & Amiram Gafni, 1989. "Quality-adjusted Life Years, Utility Theory, and Healthy-years Equivalents," Medical Decision Making, , vol. 9(2), pages 142-149, June.
    • Handle: RePEc:sae:medema:v:9:y:1989:i:2:p:142-149
    DOI: 10.1177/0272989X8900900209
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X8900900209
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X8900900209?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Mehrez, Abraham & Gafni, Amiram, 1987. "An empirical evaluation of two assessment methods for utility measurement for life years," Socio-Economic Planning Sciences, Elsevier, vol. 21(6), pages 371-375.
    2. George W. Torrance & Michael H. Boyle & Sargent P. Horwood, 1982. "Application of Multi-Attribute Utility Theory to Measure Social Preferences for Health States," Operations Research, INFORMS, vol. 30(6), pages 1043-1069, December.
    3. George W. Torrance, 1976. "Health Status Index Models: A Unified Mathematical View," Management Science, INFORMS, vol. 22(9), pages 990-1001, May.
    4. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
    5. Jeffrey P. Krischer, 1976. "Utility Structure of a Medical Decision-Making Problem," Operations Research, INFORMS, vol. 24(5), pages 951-972, October.
    6. H. V. Ravinder & Don N. Kleinmuntz & James S. Dyer, 1988. "The Reliability of Subjective Probabilities Obtained Through Decomposition," Management Science, INFORMS, vol. 34(2), pages 186-199, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Scott B. Cantor, 2004. "Clinical Applications in the Decision Analysis Literature," Decision Analysis, INFORMS, vol. 1(1), pages 23-25, March.
    2. Charles M. Harvey & Lars Peter Østerdal, 2010. "Cardinal Scales for Health Evaluation," Decision Analysis, INFORMS, vol. 7(3), pages 256-281, September.
    3. Hougaard, Jens Leth & Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2013. "A new axiomatic approach to the evaluation of population health," Journal of Health Economics, Elsevier, vol. 32(3), pages 515-523.
    4. MORENO-TERNERO, Juan & OSTERDAL, Lars P., 2014. "Normative foundations for equity-sensitive population health evaluation functions," LIDAM Discussion Papers CORE 2014031, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    5. D. Stratmann‐Schoene & T. Kuehn & R. Kreienberg & R. Leidl, 2006. "A preference‐based index for the SF‐12," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 553-564, June.
    6. Marie-Josée Dion & Pierre Tousignant & Jean Bourbeau & Dick Menzies & Kevin Schwartzman, 2002. "Measurement of Health Preferences among Patients with Tuberculous Infection and Disease," Medical Decision Making, , vol. 22(1_suppl), pages 102-114, September.
    7. Dolan, Paul, 1996. "Modelling valuations for health states: the effect of duration," Health Policy, Elsevier, vol. 38(3), pages 189-203, December.
    8. Mehrez, A. & Yuan, Y. & Gafni, A., 1995. "The search for information -- A patient perspective on multiple opinions," European Journal of Operational Research, Elsevier, vol. 85(2), pages 244-262, September.
    9. Arthur E. Attema & Matthijs M. Versteegh & Mark Oppe & Werner B. F. Brouwer & Elly A. Stolk, 2013. "Lead Time Tto: Leading To Better Health State Valuations?," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 376-392, April.
    10. John Brazier & Mark Deverill, 1999. "A checklist for judging preference‐based measures of health related quality of life: Learning from psychometrics," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 41-51, February.
    11. Hammer, Jeffrey S., 1992. "To prescribe or not to prescribe: On the regulation of pharmaceuticals in less developed countries," Social Science & Medicine, Elsevier, vol. 34(9), pages 959-964, May.
    12. Busschbach, Jan J. V. & McDonnell, Joseph & Essink-Bot, Marie-Louise & van Hout, Ben A., 1999. "Estimating parametric relationships between health description and health valuation with an application to the EuroQol EQ-5D," Journal of Health Economics, Elsevier, vol. 18(5), pages 551-570, October.
    13. David Feeny, 2012. "The Multi-attribute Utility Approach to Assessing Health-related Quality of Life," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 36, Edward Elgar Publishing.
    14. Coast, Joanna, 2009. "Maximisation in extra-welfarism: A critique of the current position in health economics," Social Science & Medicine, Elsevier, vol. 69(5), pages 786-792, September.
    15. Benjamin M. Craig & Jan J. V. Busschbach, 2011. "Toward a more universal approach in health valuation," Health Economics, John Wiley & Sons, Ltd., vol. 20(7), pages 864-875, July.
    16. Groothuis-Oudshoorn, Catharina G.M. & Chorus, Astrid M.J. & Taeke van Beekum, W. & Detmar, Symone B. & van den Hout, Wilbert B., 2006. "Modelling and estimation of valuations for the Dutch London Handicap Scale," Journal of Health Economics, Elsevier, vol. 25(6), pages 1119-1138, November.
    17. Zafar Hakim & Dev S. Pathak, 1999. "Modelling the EuroQol data: a comparison of discrete choice conjoint and conditional preference modelling," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 103-116, March.
    18. Kwak, Seung-Jun & Yoo, Seung-Hoon & Kim, Tai-Yoo, 2001. "A constructive approach to air-quality valuation in Korea," Ecological Economics, Elsevier, vol. 38(3), pages 327-344, September.
    19. Coast, Joanna & Smith, Richard D. & Lorgelly, Paula, 2008. "Welfarism, extra-welfarism and capability: The spread of ideas in health economics," Social Science & Medicine, Elsevier, vol. 67(7), pages 1190-1198, October.
    20. Claude Le Pen, 1997. "Théorie de l'utilité et mesure des états de santé, le débat QALYs-HYEs," Économie et Prévision, Programme National Persée, vol. 129(3), pages 37-54.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:9:y:1989:i:2:p:142-149. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.