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Med Decis Making. 2015 Jan;35(1):81-93. doi: 10.1177/0272989X14541328. Epub 2014 Jul 23.

Measuring family HRQoL spillover effects using direct health utility assessment.

Author information

1
Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan Health System, Ann Arbor, MI (LAP, KL, AG)
2
School of Public Health, University of Michigan, Ann Arbor, MI (LAP)
3
Center for Health Decision Science, Harvard School of Public Health, Boston, MA (EW)

Abstract

BACKGROUND:

Applications of cost-effectiveness analysis do not typically incorporate effects on caregiver quality of life despite increasing evidence that these effects are measurable.

METHODS:

Using a national sample of US adults, we conducted 2 cross-sectional surveys during December 2011 and January 2012. One version asked respondents to value their own experience as the family member of a person with a chronic illness (experienced sample), and the other version asked respondents to value hypothetical scenarios describing the experience of having a family member with a chronic illness (community sample). Conditions included Alzheimer's disease/dementia, arthritis, cancer, and depression. Using standard gamble questions, respondents were asked to value the spillover effects of a family member's illness. We used regression analysis to evaluate the disutility (loss in health-related quality of life) of having a family member with a chronic illness by condition and relationship type, controlling for the respondent's own conditions and sociodemographic characteristics.

RESULTS:

For the experienced sample (n = 1389), regression analyses suggested that greater spillover was associated with certain conditions (arthritis, depression) compared with other conditions (Alzheimer's disease, cancer). For the community sample (n = 1205), regression analyses indicated that lower spillover was associated with condition (cancer) but not the type of relationship with the ill family member (parent, child, spouse).

CONCLUSIONS:

The effects of illness extend beyond the individual patient to include effects on caregivers of patients, parents of ill children, spouses, and other close family and household members. Cost-effectiveness analyses should consider the inclusion of health-related quality of life spillover effects in addition to caregiving time costs incurred by family members of ill individuals.

KEYWORDS:

caregivers; cost-effectiveness analysis; family; health utility; health-related quality of life

PMID:
25057048
PMCID:
PMC4270843
DOI:
10.1177/0272989X14541328
[Indexed for MEDLINE]
Free PMC Article

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