ArticlePopulation health metrics2011
Decomposing cross-country differences in quality adjusted life expectancy: the impact of value sets.
Article in Population health metrics, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Cost-Effectiveness of Personalised Nutrition in Adults With Overweight and Obesity: PREVENTOMICS Studies in Poland and the UK.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025Trial
- Optimizing presentation formats for SF-6Dv2 health status valuation: a qualitative study using cognitive interviews.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Quality-Adjusted Life Expectancy Norms Based on the EQ-5D-5L and SF-6Dv2 for China.Applied health economics and health policy · 2025Article
- Quality-adjusted life expectancy norms for the Iranian population.Population health metrics · 2025Article
- Decomposing the gaps in healthy and unhealthy life expectancies between Indigenous and non-Indigenous Australians: a burden of disease and injury study.Population health metrics · 2024Article
- Informal Care Costs According to Age and Proximity to Death to Support Cost-Effectiveness Analyses.PharmacoEconomics · 2023Article
- Future medical and non-medical costs and their impact on the cost-effectiveness of life-prolonging interventions: a comparison of five European countries.The European journal of health economics : HEPAC : health economics in prevention and care · 2023Article
- Inequality in quality-adjusted life expectancy by educational attainment in Norway: an observational study.BMC public health · 2023Observational
- Changes in quality-adjusted life expectancy in Belgium, 2013 and 2018.Archives of public health = Archives belges de sante publique · 2022Article
- Conceptual Framework for Optimised Proxy Value Set Selection Through Supra-National Value Set Development for the EQ-5D Instruments.PharmacoEconomics · 2022Review
- QALY losses for chronic diseases and its social distribution in the general population: results from the Belgian Health Interview Survey.BMC public health · 2022Article
- Quality-Adjusted Life-Years Lost Due to COVID-19 Mortality: Methods and Application for The Netherlands.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022Article
- Belgian population norms for the EQ-5D-5L, 2018.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Article
- Use of a Non-parametric Bayesian Method to Model Health State Preferences: An Application to Polish and Irish EQ-5D-5L Valuations.Frontiers in public health · 2022Article
- Article
- Severity-Adjusted Probability of Being Cost Effective.PharmacoEconomics · 2019Article
- Valuation of preference-based measures: can existing preference data be used to generate better estimates?Health and quality of life outcomes · 2018Article
- Bayesian nonparametric estimation of EQ-5D utilities for United States using the existing United Kingdom data.Health and quality of life outcomes · 2017Article
- Quality-of-life: a many-splendored thing? Belgian population norms and 34 potential determinants explored by beta regression.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2017Article
- International comparison of experience-based health state values at the population level.Health and quality of life outcomes · 2017Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL). We focused on the impact of value set choice on cross-country variation.
methodsWe calculated Quality Adjusted Life Expectancy (QALE) at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE.
resultsQALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries.
conclusionsThe choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers of differences in health-state values across populations. This will enhance the usefulness of health-expectancy measures.
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Registered trials
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