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Mapping Health Status Measures to a Utility Measure in a Study of Nursing Home Residents With Advanced Dementia

Bibliographic Data

ID9104538
AuthorsKeith Goldfeld (0000-0002-0292-8780, Columbia University, corresponding author), Keith S Goldfeld, Mary Beth Hamel (Hadassah Medical Center), Susan L Mitchell (Hebrew SeniorLife)
Year2012
Volume50
Issue5
Pages446-451
Publication date2012-05-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3182407e0d
PMID22635251
PMCIDPMC3549579
OpenAlexW2030370647
LanguageEN
Citations received2
References cited18

BACKGROUND: Nursing home residents with advanced dementia commonly experience burdensome and costly interventions (eg, hospitalization) of questionable clinical benefit. To facilitate cost-effectiveness analyses of these interventions, utility-based measures are needed in order to estimate quality-adjusted outcomes. METHODS: Nursing home residents with advanced dementia in 22 facilities were followed for 18 months (N=319). Validated health status measures ascertained from nurses at baseline, quarterly, and death (N=1702 assessments) were mapped to the Health Utilities Index Mark 2 [range, 1 (perfect health) to 0 (death); scores below 0 indicate states worse than death]. To assess validity, utility scores were compared between residents who did and did not receive burdensome interventions (parenteral therapy, percutaneous endoscopic gastrostomy tubes, and hospital transfers), residents with and without pneumonia, and residents who did and did not die at the last assessment. RESULTS: Mean (±SD) Health Utilities Index Mark 2 utility score for the cohort was 0.165±0.060 (range, -0.005 to 0.215). Residents spent an average of 15.5% of their days with utilities <0.10. Lower utility scores were found among residents who received burdensome interventions (0.152±0.067 vs. 0.171±0.056; P=0.0003); had pneumonia (0.147±0.066 vs. 0.170±0.057; P=0.003); and were dying (0.163±0.057 vs. 0.180±0.055; P=0.006). CONCLUSIONS: It is feasible to map health status measures to utility-based measures for advanced dementia. This work will facilitate future cost-effectiveness analyses aimed at quantifying the cost of interventions relative to quality-based outcomes for patients with this condition

Dementia · Disease · Health care · Health related quality of life · Health Utilities Index · MEDLINE · Percutaneous endoscopic gastrostomy · Psychological intervention · Emergency Medicine · Geriatric Care and Nursing Homes · Health Systems, Economic Evaluations, Quality of Life · Medicine · Nursing · Palliative Care and End-of-Life Issues · Gerontology

  • An empirical comparison of the measurement properties of the EQ-5D-5L, Demqol-U and Demqol-Proxy-U for older people in residential care

    Open Access•Tiffany Easton, Rachel Milte et al.•Quality of Life Research•2018

  • Preferred reporting items for studies mapping onto preference-based outcome measures

    Open Access•Stavros Petrou, Oliver Rivero-Arias et al.•Quality of Life Research•2015

  • The estimation of a preference-based measure of health from the SF-36

    Open Access•John Brazier, Jennifer Roberts et al.•Journal of Health Economics•2002

  • Multiattribute Utility Function for a Comprehensive Health Status Classification System

    George W Torrance, David H Feeny et al.•Medical Care•1996

  • Health Utilities in Alzheimer's Disease

    Peter J Neumann, Karen M Kuntz et al.•Medical Care•1999

  • Assessing Quality of Life in Dementia

    Caroline Selai•Medical Care•2001

Unique citing works2
Citations per year0,18
Citation span2015 - 2018 (4)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2

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