PACE publication: the use of quality-adjusted life year (QALY) in palliative care
The paper is about the use of the quality-adjusted life year (QALY) in palliative care. The QALY is the most often used outcome measure of effectiveness in cost-effectiveness analyses in health care, and we will also use it in PACE study II. However; a debate concerning the appropriateness of its use in palliative and end-of-life care is ongoing. Because of the importance of this discussion, and to reflect on our own choice to use the QALY, we systematically mapped pros and cons of using the QALY in palliative care as brought forward in the debate, and discuss the QALYs value for palliative care.
Our review concludes that the QALY might be of value for palliative care. However, since standard quality-of-life measurement instruments (such as the EQ-5D) lack dimensions that are essential to palliative care, we recommend to add quality-of-life or capability instruments. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the QALY framework, in which linear valuation is currently assumed. Moreover, we argue that the issues suggested should not remain restricted to palliative care, but be considered in the QALY conceptualization throughout healthcare. Which meets Huber’s new concept of health (Huber, BMJ 2011, How should we define health?).
Enjoy the read!
Anne Wichmann, Msc. MA.
Promovenda PACE - PAlliative Care for Elderly in care and nursing homes in Europe
European Commission Project (7th Framework Programme)
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Radboud university medical center
Radboud Institute for Health Sciences
Scientific Center for Quality of Healthcare (IQ healthcare)
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