Moving the QALY Forward: Rationale for Change

Smith, Marilyn Dix; Drummond, Michael; Brixner, Diana

doi:10.1111/j.1524-4733.2009.00514.x

Cited by 48 publications

(31 citation statements)

References 4 publications

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“…Third, the VR-6D allows the analyst to calculate quality adjusted life years (QALYs) from the VR-12 [32,33]. Today, QALYs are used in most economic evaluations, and by many regulatory agencies, which have made cost-effectiveness analysis an integral part of their decision-making processes for purposes of resource allocation decisions [34].…”

Section: Discussionmentioning

confidence: 99%

A preference-based measure of health: the VR-6D derived from the veterans RAND 12-Item Health Survey

et al. 2011

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Section: Discussionmentioning

confidence: 99%

A preference-based measure of health: the VR-6D derived from the veterans RAND 12-Item Health Survey

et al. 2011

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“…It assumes the decision maker acts on behalf of society and aims to maximize health given available resources [14 ]. This preference for monetary measurements creates difficulties for decision makers and politicians as the general population may disagree with valuing life in purely financial terms [16][17][18][19][20].…”

Section: Standard Tools For Economic Evaluationsmentioning

confidence: 99%

The relationship between economic evaluations and HIV and AIDS treatment policies

Taleski

Ahmed

Whiteside

2010

Current Opinion in HIV and AIDS

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Consideration of the ways in which economic evaluations can have greater influence over HIV and AIDS policies is needed. The weak relationship between the two reflects the complicated and multifaceted decision-making process that is often influenced by socioeconomic and political factors. If an economic evaluation is to influence policy, then cognizance of this is important. Extending the economic toolkit to include broader-based models that incorporate political economy variables, but do not compromise on comprehension, validity and robustness, will offer better informed policy recommendations.

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“…[52][53][54][55] Some progressive medical groups are aware of this, but more effort is needed at all levels to promote this culture change more widely. One current opportunity to address this issue and incorporate patient-reported measures is the organization and provision of care through patient-centered medical homes.…”

Section: Implications and Opportunitiesmentioning

confidence: 99%

Patient-Reported Measures Of Psychosocial Issues And Health Behavior Should Be Added To Electronic Health Records

et al. 2012

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Recent legislation and delivery system reform efforts are greatly expanding the use of electronic health records. For these efforts to reach their full potential, they must actively involve patients and include patient-reported information about such topics as health behavior, preferences, and psychosocial functioning. We offer a plan for including standardized, practical patient-reported measures as part of electronic health records, quality and performance indexes, the primary care medical home, and research collaborations. These measures must meet certain criteria, including being valid, reliable, sensitive to change, and available in multiple languages. Clinicians, patients, and policy makers also must be able to understand the measures and take action based on them. Including more patient-reported items in electronic health records would enhance health, patient-centered care, and the capacity to undertake population-based research. R ecent health care reforms, including the Affordable Care Act of 2010, the Health Information Technology for Economic and Clinical Health (HITECH) provisions of the American Recovery and Reinvestment Act of 2009, 1 and patient-centered medical home initiatives, 2 place a new emphasis on electronic health records. Within a relatively short period of time, the majority of patient encounters with the health system will be captured electronically. This change from current practice will make the US health care system more similar to the efficient systems in other countries such as the United Kingdom, where nearly 95 percent of physicians use electronic data capture.3 The arrival of the electronic age in health care has the potential to revolutionize patient care by supplying efficient tools to better personalize care and manage populations.This new era will also change clinical health research, because information will be available on millions of encounters in real-world settings, and will make possible rapid-learning health care systems. 4,5 Unfortunately, there is a real danger that data on key patient information and some of the most important determinants of health might not be captured unless specific efforts are undertaken to include those data. This article proposes a list of behavioral and psychosocial data that could be included in electronic health records and addresses long-standing objections to their inclusion.Most electronic health records capture aspects of medical encounters between patients and practitioners, but only from the perspective of providers and payers. A comprehensive understanding of health and optimal treatment of patients requires additional types of information. By all expert estimates, most factors that influence life expectancy and health-related quality of life are outside the health care system. 6,7

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Moving the QALY Forward: Rationale for Change

Cited by 48 publications

References 4 publications

A preference-based measure of health: the VR-6D derived from the veterans RAND 12-Item Health Survey

A preference-based measure of health: the VR-6D derived from the veterans RAND 12-Item Health Survey

The relationship between economic evaluations and HIV and AIDS treatment policies

Patient-Reported Measures Of Psychosocial Issues And Health Behavior Should Be Added To Electronic Health Records

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