Abstract
BackgroundAccurately assessing changes in the quality of life of older people living permanently in nursing homes is important. The multi-attribute utility instrument most commonly used and recommended to assess health-related quality of life in the nursing home population is the three-level EuroQol EQ-5D-3L. To date, there have been no studies using the Health Utilities Index Mark III (HUI3). The purpose of this study was to compare the level of agreement and sensitivity to change of the EQ-5D-3L and HUI3 in a nursing home population.MethodsEQ-5D-3L and HUI3 scores were measured as part of a cluster randomised controlled trial of nurse led care coordination in a nursing home population in Perth, Western Australia at baseline and 6-month follow up.ResultsBoth measures were completed for 199 residents at baseline and 177 at 6-month follow-up. Mean baseline utility scores for EQ-5D-3L (0.45; 95% CI 0.41–0.49) and HUI3 (0.15; 95% CI 0.10–0.20) were significantly different (Wilcoxon signed rank test, p<0.01) and agreement was poor to moderate between absolute scores from each instrument (intra-class correlation coefficient = 0.63). The EQ-5D-3L appeared more sensitive to change over the 6-month period.ConclusionOur findings show that the EQ-5D-3L and HUI3 estimate different utility scores among nursing home residents. These differences should be taken into account, particularly when considering the implications of the cost-effectiveness of particular interventions and we conclude that the HUI3 is no better suited to measuring health-related quality of life in a nursing home population when compared to the EQ-5D-3L.
Highlights
The growth in the proportion of older people [1] and those who live permanently in a nursing home requiring complex care has implications both for health service delivery and the increase in demand of expenditure in order to meet this need [2]
Mean baseline utility scores for EQ-5D-3L (0.45; 95% CI 0.41–0.49) and Health Utilities Index Mark 3 (HUI3) (0.15; 95% CI 0.10–0.20) were significantly different (Wilcoxon signed rank test, p
We investigated agreement and sensitivity to change for utility scores based on the EQ-5D-3L and HUI3, providing insight into the differences between these two instruments for people living in a nursing home
Summary
The growth in the proportion of older people [1] and those who live permanently in a nursing home requiring complex care has implications both for health service delivery and the increase in demand of expenditure in order to meet this need [2]. Health-related quality-oflife (HRQoL), measured using a multi-attribute utility instrument (MAUI), provides a summary score that estimates quality of life (QoL). These scores, in combination with survival estimates, are typically used in health economic evaluations of different interventions to estimate quality adjusted life years (QALYs) [3]. Assessing changes in the quality of life of older people living permanently in nursing homes is important. The multi-attribute utility instrument most commonly used and recommended to assess health-related quality of life in the nursing home population is the three-level EuroQol EQ-5D-3L. The purpose of this study was to compare the level of agreement and sensitivity to change of the EQ-5D-3L and HUI3 in a nursing home population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
