title: Effect of health-related quality-of-life instrument and quality-adjusted life year calculation method on the number of life years gained in the critical care setting.
abstract: OBJECTIVE
  Health-related quality of life (HRQoL) and quality-adjusted life-years (QALYs) gained are basic elements in the cost-utility evaluations of health care. Different HRQoL instruments produce different scores for the same patient, and thus also a different number of QALYs. We examined the effect of these factors on the number of QALYs gained and the cost per QALY in the critical care setting.
  
  
  METHODS
  In 937 patients having been treated in the critical care setting in the Helsinki University Central Hospital the HRQoL scores were measured by the EQ-5D and 15D 6 and 12 months after start of treatment, and QALYs were calculated using four different sets of assumptions regarding recovery from disease.
  
  
  RESULTS
  The mean number of QALYs gained during the first year after treatment ranged from 0.178 ± 0.206 to 0.550 ± 0.508 and the consequent cost per QALY from €38,405 to €118,668 depending on HRQoL instrument and assumptions used in the calculations regarding recovery from disease.
  
  
  CONCLUSIONS
  The HRQoL instrument and the assumptions employed regarding recovery from disease have a great influence on the results of cost-utility analyses and should, therefore, be explicitly described in studies reporting QALYs. Furthermore, a common consensus on which calculation method should be used within critical care would be urgently needed.
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland. tvainiol@mappi.helsinki.fi
authors.forename: Tarja
authors.initials: T
authors.lastname: Vainiola
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
authors.forename: Taru
authors.initials: T
authors.lastname: Kantola
authors.forename: Pirjo
authors.initials: P
authors.lastname: Räsänen
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
mesh_terms: D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics / Q000706:statistics & numerical data*; D005387:Finland; D017048:Health Care Costs; D006785:Hospitals, University; D006801:Humans; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013997:Time Factors