Resource allocation decisions in health care: a role for quality of life assessments?

This paper discusses the relevance of quality of life measurement in clinical and epidemiological research to resource allocation decisions in health care. The discussion concentrates on economic evaluations, the form of health services research which most directly pertains to decisions about the allocation of resources, and the use of the quality-adjusted life-year in economic evaluation. Three key issues are addressed: whose assessments of quality of life are relevant and how should these be obtained; should one search for a generalizable quality of life measure; is it right to construct "league tables" of health care interventions in terms of cost per quality-adjusted life-year?