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A Proposed Method for Monitoring U.S. Population Health: Linking Symptoms, Impairments, and Health Ratings

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  • Susan T. Stewart
  • Rebecca M. Woodward
  • Allison B. Rosen
  • David M. Cutler

Abstract

We propose a method of quantifying non-fatal health on a 0-1 QALY scale that details the impact of specific symptoms and impairments and is not based on ratings of counterfactual scenarios. Measures of general health status are regressed on health impairments and symptoms in different domains, using ordered probit and ordinary least squares regression. This yields estimates of their effects analogous to disutility weights, and accounts for complex non-additive relationships. Health measures used include self-rated health status on a 5-point scale, EuroQol 5D (EQ-5D) scores, and ratings of current health using a 0-100 rating scale and a time-tradeoff. Data are from the nationally representative Medical Expenditure Panel Survey (MEPS) year 2002 (N=34,615), with validation in an independent sample from MEPS 2000 (N=21,067) and among 1420 adults age 45-89 in the Beaver Dam Health Outcomes Study. Decrement weights for symptoms and impairments are used to derive estimates of overall health-related quality of life, laying the groundwork for a detailed national summary measure of health. To purchase a copy of the earlier version of this paper, please contact the Working Papers department directly at (617) 588 1405.

Suggested Citation

  • Susan T. Stewart & Rebecca M. Woodward & Allison B. Rosen & David M. Cutler, 2005. "A Proposed Method for Monitoring U.S. Population Health: Linking Symptoms, Impairments, and Health Ratings," NBER Working Papers 11358, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:11358
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    References listed on IDEAS

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    1. Dennis G. Fryback & Erik J. Dasbach & Ronald Klein & Barbara E.K. Klein & Norma Dorn & Kathy Peterson & Patrica A. Martin, 1993. "The Beaver Dam Health Outcomes study," Medical Decision Making, , vol. 13(2), pages 89-102, June.
    2. Brazier, John & Roberts, Jennifer & Deverill, Mark, 2002. "The estimation of a preference-based measure of health from the SF-36," Journal of Health Economics, Elsevier, vol. 21(2), pages 271-292, March.
    3. Richard Holland & Richard D Smith & Ian Harvey & Louise Swift & Elizabeth Lenaghan, 2004. "Assessing quality of life in the elderly: a direct comparison of the EQ‐5D and AQoL," Health Economics, John Wiley & Sons, Ltd., vol. 13(8), pages 793-805, August.
    4. Fýlkesnes, Knut & Førde, Olav Helge, 1992. "Determinants and dimensions involved in self-evaluation of health," Social Science & Medicine, Elsevier, vol. 35(3), pages 271-279, August.
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    Cited by:

    1. Guido Citoni, 2006. "Are people from Brussels and walloons more optimistic about their health?," Brussels Economic Review, ULB -- Universite Libre de Bruxelles, vol. 49(4), pages 311-332.
    2. Qing Li & Alain A. Cohen & Linda P. Fried, 2017. "A novel health metric based on biomarkers," Cahiers de recherche 17-08, Departement d'économique de l'École de gestion à l'Université de Sherbrooke.
    3. Erik Meijer & Arie Kapteyn & Tatiana Andreyeva, 2011. "Internationally comparable health indices," Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 600-619, May.
    4. Erik Meijer & Arie Kapteyn & Tatiana Andreyeva, 2008. "Health Indexes and Retirement Modeling in International Comparisons," Working Papers 614, RAND Corporation.

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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