National Institute for Health and Welfare, Helsinki, Finland.
Value Health. 2011 Dec;14(8):1130-4. doi: 10.1016/j.jval.2011.05.047. Epub 2011 Aug 19.
Health-related quality of life (HRQoL) and quality-adjusted life-years (QALYs) gained are basic elements in the cost-utility evaluations of health care. Different HRQoL instruments produce different scores for the same patient, and thus also a different number of QALYs. We examined the effect of these factors on the number of QALYs gained and the cost per QALY in the critical care setting.
In 937 patients having been treated in the critical care setting in the Helsinki University Central Hospital the HRQoL scores were measured by the EQ-5D and 15D 6 and 12 months after start of treatment, and QALYs were calculated using four different sets of assumptions regarding recovery from disease.
The mean number of QALYs gained during the first year after treatment ranged from 0.178 ± 0.206 to 0.550 ± 0.508 and the consequent cost per QALY from €38,405 to €118,668 depending on HRQoL instrument and assumptions used in the calculations regarding recovery from disease.
The HRQoL instrument and the assumptions employed regarding recovery from disease have a great influence on the results of cost-utility analyses and should, therefore, be explicitly described in studies reporting QALYs. Furthermore, a common consensus on which calculation method should be used within critical care would be urgently needed.
健康相关生活质量（HRQoL）和质量调整生命年（QALYs）是医疗保健成本效用评估的基本要素。不同的 HRQoL 工具会为同一患者产生不同的分数，因此也会产生不同数量的 QALYs。我们研究了这些因素对重症监护环境中获得的 QALYs 数量和每 QALY 成本的影响。
在赫尔辛基大学中心医院的重症监护环境中治疗的 937 名患者中，使用 EQ-5D 和 15D 在治疗开始后 6 个月和 12 个月测量 HRQoL 评分，并使用四种不同的疾病康复假设来计算 QALYs。
治疗后第一年获得的 QALYs 平均值范围为 0.178±0.206 至 0.550±0.508，相应的每 QALY 成本为 38405 欧元至 118668 欧元，具体取决于使用的 HRQoL 工具和用于计算疾病康复假设的工具。
HRQoL 工具和用于计算疾病康复的假设对成本效用分析的结果有很大影响，因此在报告 QALYs 的研究中应明确描述。此外，重症监护领域内应该迫切需要就应该使用哪种计算方法达成共识。
