Abstract
BackgroundGlobal research shows a clear transition in health outcomes over the past two decades where improved survival was accompanied by lower health related quality of life (HRQoL) as measured by morbidity and disability. These trends suggest the need to better understand changes in population HRQoL. This paper compares two perspectives on population HRQoL change using burden of disease morbidity estimates from administrative data and self-reports from random and representative population surveys.MethodsSouth Australian administrative data including inpatient hospital activity, cancer and communicable disease registrations were used within a Burden of Disease study framework to quantify morbidity as Prevalent Years of Life lived with Disease and injury related illness (PYLD) for 1999 to 2008. Self-reported HRQoL was measured using the Assessment of Quality of Life (AQoL) in face to face interviews with at least 3000 respondents in each of South Australia’s Health Omnibus Surveys (HOS) in 1998, 2004 and 2008.ResultsAge specific PYLD rates for those aged 75 or more increased by 5.1%. HRQoL dis-utility in this age group also increased significantly and beyond the minimally important difference threshold. Underlying increased dis-utility were greater difficulties in independent living (particularly requiring help with household tasks) and psychological well-being (as influenced by pain, discomfort and difficulty sleeping).ConclusionsConsistent with increased quantity of life being accompanied by reduced HRQoL, the analysis indicates older people in South Australia experienced increased morbidity in the decade to 2008. The results warrant routine monitoring of health dis-utility at a population level and improvement to the supply and scope of administrative data.
Highlights
Global research shows a clear transition in health outcomes over the past two decades where improved survival was accompanied by lower health related quality of life (HRQoL) as measured by morbidity and disability
While changes in a population’s health are often expressed in terms of quantity, using life expectancy or mortality rates, such measures overlook health related quality of life (HRQoL). The latter is increasingly important to monitor as recent international research shows a clear transition in health outcomes over the past two decades whereby improved survival was
The South Australian series adjusts morbidity parameters according to yearly changes in sex and age groups for conditions observed in routinely available administrative data
Summary
Global research shows a clear transition in health outcomes over the past two decades where improved survival was accompanied by lower health related quality of life (HRQoL) as measured by morbidity and disability These trends suggest the need to better understand changes in population HRQoL. While changes in a population’s health are often expressed in terms of quantity, using life expectancy or mortality rates, such measures overlook health related quality of life (HRQoL) The latter is increasingly important to monitor as recent international research shows a clear transition in health outcomes over the past two decades whereby improved survival was. While it is feasible to do so using simulation methods [8,10,11], this was beyond the scope of the SA SMPH series because of the resourcing challenges associated with developing maintaining condition-specific models [8], for a single jurisdiction [3]
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