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QALYs in mental health: a case study

Published online by Cambridge University Press:  09 July 2009

Greg Wilkinson*
Affiliation:
Department of Psychiatry, The London Hospital Medical College; Academic Sub-department of Psychological Medicine, North Wales Hospital, Denbigh, Clwyd; and Buckingham Mental Health Service, Buckingham
Brian Williams
Affiliation:
Department of Psychiatry, The London Hospital Medical College; Academic Sub-department of Psychological Medicine, North Wales Hospital, Denbigh, Clwyd; and Buckingham Mental Health Service, Buckingham
H. Krekorian
Affiliation:
Department of Psychiatry, The London Hospital Medical College; Academic Sub-department of Psychological Medicine, North Wales Hospital, Denbigh, Clwyd; and Buckingham Mental Health Service, Buckingham
S. McLees
Affiliation:
Department of Psychiatry, The London Hospital Medical College; Academic Sub-department of Psychological Medicine, North Wales Hospital, Denbigh, Clwyd; and Buckingham Mental Health Service, Buckingham
I. Falloon
Affiliation:
Department of Psychiatry, The London Hospital Medical College; Academic Sub-department of Psychological Medicine, North Wales Hospital, Denbigh, Clwyd; and Buckingham Mental Health Service, Buckingham
*
1 Address for correspondence: Professor Greg Wilkinson, Department of Psychiatry, The London Hospital Medical College, Turner Street, London E1 2AD.

Synopsis

The applicability of the Charing Cross health indicator (CH-X) to the field of mental health was investigated in a community setting using descriptive statistics and principal components analysis. The CH-X is based on assessments of (i) distress and (ii) disability. Our results suggest that with respect to quality of life in mental health settings measurements of distress may be of greater importance than disability. In addition, the CH-X may be insensitive to variations in the severity of mental disorder and may primarily reflect physical disability as opposed to social disability. QALYs methodology may require the adoption of a multidimensional measure of health in order to fulfil its proposed role in comparing medical and mental health programmes.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1992

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References

REFERENCES

Bergner, M., Bobbitt, R., Carter, W. & Gilson, B. (1981). The sickness impact profile: development and final revision of a health status measure. Medical Care 19, 787805.CrossRefGoogle ScholarPubMed
Carr-Hill, R. & Morris, J. (1991). Current practice in obtaining the ‘Q’ in QALYs: a cautionary note. British Medical Journal 303, 699701.CrossRefGoogle Scholar
Donaldson, C., Atkinson, A., Bond, J. & Wright, K. (1988). Should QALYs be programme-specific? Journal of Health Economics 14, 229256.Google Scholar
Drummond, M. F., Stoddart, G. L. & Torrance, G. W. (1987). Methods for the Economic Evaluation of Health Care Programmes. Oxford: Oxford University Press.Google Scholar
Gudex, C. (1986). QALYs and their use by the Health Service, Discussion paper no. 20. York: Centre for Health Economics.Google Scholar
Gudex, C. & Kind, P. (1988). The QALY toolkit, Discussion paper no. 38. York: Centre for Health Economics.Google Scholar
Guy, W. (1976). Assessment Manual for Psychopharmacology. DHEW Publication revised No. (ADM) 76–338. US Government Printing Office: Washington, DC.Google Scholar
Hunt, S., McKenna, S., McEwan, J., Beckett, E., Williams, J. & Papp, E. (1980). A quantitative approach to perceived health status: a validation study. Journal of Epidemiology and Community Health 34, 281286.CrossRefGoogle ScholarPubMed
Pickard, J. D., Bailey, S., Sanderson, H., Rees, M. & Garfield, J. S. (1990). Steps towards cost-benefit analysis of regional neurosurgical care. British Medical Journal 301, 629635.CrossRefGoogle ScholarPubMed
Rosser, R. M. (1974). The measurement of hospital output – a care study. Excerpt from the Royal Society of Health Congress, Brighton 22–26 04, 1974.Google Scholar
Rosser, R. M. (1990). From health indicators to quality adjusted life years: technical and ethical issues. In Measuring the Outcomes of Medical Care (Ed. Hopkins, A. and Costain, D.). pp. 117. Royal College of Physicians: London.Google Scholar
Rosser, R. M. & Kind, P. (1978). A scale of valuation of states of illness: Is there a social consensus? International Journal of Epidemiology 7, 347357.CrossRefGoogle Scholar
Rosser, R. M. & Watts, V. C. (1972). The measurement of hospital output. International Journal of Epidemiology 1, 361368.CrossRefGoogle ScholarPubMed
Rosser, R. M. & Watts, V. C. (1978). The measurement of illness. Journal of Operational Research 29, 529540.CrossRefGoogle ScholarPubMed
Tarlov, A. R., Ware, J. E., Greenfield, S., Nelson, E. C., Perrin, E. & Zubkoff, M. (1989). The Medical Outcomes Study. An application of methods for monitoring the results of medical care. Journal of the American Medical Association 262, 925930.CrossRefGoogle ScholarPubMed
WHO (1978). Mental Disorder: Glossary and Guide to Their Classification in Accordance with the Ninth Revision of the International Classification of Disease. World Health Organization: Geneva.Google Scholar