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© 1991 Oxford University Press

research-article

The Valuation of States of III-health: the Impact of Age and Disability

SHAH EBRAHIM, SARAJANE BRITTIS and ALEX WU

Department of Health Care of the Elderly, The London Hospital Medical College Bancroft Road, London E1 4DG
Department of Geriatric Medicine, Royal Free Hospital Pond Street, London NW3 2QG

The effects of age and disability on valuations of health states used in deriving QALYs have not been examined. We compared the valuations of seven states of immobility and pain given by 88 subjects aged 20–89 years, and of various degrees of disability. They were asked to score each state, their present health and death, on a range from ‘best’ to ‘worst’ health.

Only two states of health (no disability but moderate pain, and slight disability and moderate pain) were valued differently by older subjects. Disabled subjects tended to rate most ill-health states more adversly, and to rate death as substantially better than more severe states of ill-health. The development of explicit valuations of survival should take into account differences caused by disability, and examine other dimensions of illness experience.

Received March 26, 1990;
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