title: A long life in good health: subjective expectations regarding length and future health-related quality of life.
abstract: BACKGROUND
  Subjective life expectancy is considered relevant in predicting mortality and future demand for health services as well as for explaining peoples' decisions in several life domains, such as the perceived impact of health behaviour changes on future health outcomes. Such expectations and in particular subjective expectations regarding future health-related quality of life remain understudied. The purpose of this study was to investigate individuals' subjective quality adjusted life years (QALYs) expectation from age 65 onwards in a representative sample of the Dutch generic public.
  
  
  METHODS
  A web-based questionnaire was administered to a sample of the adult population from the Netherlands. Information on subjective expectations regarding length and future health-related quality of life were combined into one single measure of subjective expected QALYs from age 65 onwards. This subjective QALY expectation was related to background, health and lifestyle variables. The implications of using different methods to construct our main outcome measure were addressed.
  
  
  RESULTS
  Mean subjective expected QALYs from age 65 onwards was 11 QALYs (range -9 to 40 QALYs). Individuals with unhealthier lifestyles, chronic diseases, severe disorders or lower age of death of next of kin reported lower QALY expectations. Indicators were varyingly associated with either subjective life expectancy or future health-related quality of life, or both.
  
  
  CONCLUSIONS
  Extending the concept of subjective life expectancy by correcting for expected quality of life appears to generate important additional information contributing to our understanding of people's perceptions regarding ageing and lifestyle choices.
authors.affiliation: Department of Health Policy and Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.
authors.forename: David R
authors.initials: DR
authors.lastname: Rappange
authors.affiliation: Department of Health Policy and Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.
authors.forename: Werner B F
authors.initials: WB
authors.lastname: Brouwer
authors.affiliation: Department of Health Policy and Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands. vanexel@bmg.eur.nl.
authors.forename: Job
authors.initials: J
authors.lastname: van Exel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009426:Netherlands; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Health behaviour; Life expectancy; Lifestyle; Quality of life; Subjective expectations