title: Social relationships as a major determinant in the valuation of health states.
abstract: OBJECTIVE
  To empirically determine the impact of the capacity to sustain social relationships on valuing health states.
  
  
  METHODS
  68 clinical experts conducted a health state valuation exercise in five sites using pairwise comparison, ranking, and person trade-off as elicitation methods. 23,840 pairwise comparisons of a total of 379 health states were analyzed by conditional logistic regression.
  
  
  RESULTS
  Social relationships had a clear monotonic association with perceived disability: the more limited the capacity to sustain social relationships, the more disabling the resulting health state valuations. The highest level of limitations with respect to social relationships was associated with slightly lower impact on health state valuations compared to the highest level of limitations in physical functioning.
  
  
  CONCLUSIONS
  Social relationships showed an independent contribution to health state valuations and should be included in health state measures.
authors.affiliation: Department of Healthcare Management, Carinthia University of the Applied Sciences, Hauptplatz 12, 9560, Feldkirchen, Austria. u.frick@cuas.at
authors.forename: Ulrich
authors.initials: U
authors.lastname: Frick
authors.forename: Hyacinth
authors.initials: H
authors.lastname: Irving
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D001294:Attitude to Health; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D011788:Quality of Life / Q000523:psychology*