Health Economics Unit, Public Health Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Qual Life Res. 2012 Feb;21(1):167-76. doi: 10.1007/s11136-011-9927-2. Epub 2011 May 20.
The benefits of health and social care are not confined to patient health alone and therefore broader measures of wellbeing may be useful for economic evaluation. This paper reports the development of a simple measure of capability wellbeing for adults (ICECAP-A).
In-depth, informant-led, interviews to identify the attributes of capability wellbeing were conducted with 36 adults in the UK. Eighteen semi-structured, repeat interviews were carried out to develop a capability-based descriptive system for the measure. Informants were purposively selected to ensure variation in socio-economic status, age, sex, ethnicity and health. Data analysis was carried out inductively and iteratively alongside interviews, and findings were used to shape the questions in later interviews.
Five over-arching attributes of capability wellbeing were identified for the measure: "stability", "attachment", "achievement", "autonomy" and "enjoyment". One item, with four response categories, was developed for each attribute for the ICECAP-A descriptive system.
The ICECAP-A capability measure represents a departure from traditional health economics outcome measures, by treating health status as an influence over broader attributes of capability wellbeing. Further work is required to value and validate the attributes and test the sensitivity of the ICECAP-A to healthcare interventions.
健康和社会保健的益处不仅局限于患者健康,因此更广泛的幸福感衡量标准可能对经济评估有用。本文报告了一种用于成年人的能力幸福感的简单衡量标准(ICECAP-A)的开发。
在英国,对 36 名成年人进行了深入的、由信息提供者主导的访谈,以确定能力幸福感的属性。进行了 18 次半结构化、重复访谈,以开发衡量标准的基于能力的描述系统。信息提供者是有目的地选择的,以确保在社会经济地位、年龄、性别、种族和健康方面存在差异。数据分析与访谈同时进行,并进行了归纳和迭代,研究结果用于塑造后续访谈中的问题。
确定了衡量标准的五个总体能力幸福感属性:“稳定性”、“依附”、“成就”、“自主”和“享受”。为 ICECAP-A 描述系统的每个属性开发了一个包含四个回答类别的项目。
ICECAP-A 能力衡量标准代表了对传统健康经济学结果衡量标准的背离,它将健康状况视为对更广泛的能力幸福感属性的影响。需要进一步开展工作来评估和验证属性,并测试 ICECAP-A 对医疗保健干预措施的敏感性。