ArticlePharmacoEconomics2023
Decomposition of Quality-Adjusted Life Expectancy Inequalities by Mortality and Health-Related Quality of Life Dimensions.
Article in PharmacoEconomics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- The Apparent Discrepancy Between Social Inequality in Disability-Free and Quality-Adjusted Life Expectancy.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2026Article
- Cost-effectiveness and equity impact of complex primary care interventions for disadvantaged populations.BJGP open · 2026Article
- A Method for Comparing Health Inequality Impact Magnitudes, with an Illustration for Hypothetical Treatments of 1336 Diseases.PharmacoEconomics · 2026Article
- Inequalities in Quality-Adjusted Life Expectancy in Australia by Educational Attainment.PharmacoEconomics · 2025Article
- Quality-Adjusted Life Expectancy Norms Based on the EQ-5D-5L and SF-6Dv2 for China.Applied health economics and health policy · 2025Article
- Effects of Physical Activity Level, Strength, Balance, and Body Composition on Perceived Health in Healthy Adults.Sports (Basel, Switzerland) · 2025Article
- Norms for the EQ-5D-5L among the general adult population in Alberta, Canada.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Article
- Prioritizing Patients from the Most Deprived Areas on Elective Waiting Lists in the NHS in England: Estimating the Health and Health Inequality Impact.MDM policy & practiceArticle
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Authors and funding
5 authors.
Funding
Abstract
backgroundQuality-adjusted life expectancy (QALE) combines mortality risk and multidimensional health-related quality of life (HRQoL) information to measure healthy life expectancy in terms of quality-adjusted life years (QALYs). This paper estimates the relative importance of individual quality of life dimensions in explaining inequalities in QALE.
methodsWe combined EQ-5D-5L data from the Health Survey for England for 2017 and 2018 (N = 14,412) with full population mortality data from the Office for National Statistics to calculate QALE by age, sex and deprivation quintile. The effect of HRQoL dimensions on the socioeconomic gradient in QALE was decomposed using an iterative imputation approach, in which inequalities associated with socioeconomic status in each domain were removed by imputing the response distribution of the richest quintile for all participants. Sampling uncertainty in the HRQoL data was evaluated using bootstrapping.
resultsPeople in the least deprived fifth of neighbourhoods in England can expect to live 7.0 years longer and experience 11.1 more QALYs than those in the most deprived fifth. Inequalities in HRQoL accounted for 28.0% and 45.7% of QALE inequalities for males and females, respectively. Pain/discomfort, anxiety/depression and mobility were the most influential HRQoL domains. DISCUSSION: Our results identify the extent of inequalities associated with socioeconomic status in lifetime health and the relative importance of inequalities by mortality and HRQoL. The contributions of the individual dimensions of HRQoL towards lifetime inequalities vary substantially by sex. Our findings can help to identify the types of interventions most likely to alleviate health inequalities, which may be different for males and females.
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