Abstract
Background: Although the life expectancy for the US population has increased, a high proportion of this population has lived with =1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for older US adults. Research Design: Data were from the Medicare Health Outcomes Survey Cohort 15 (baseline survey in 2012, follow-up survey 2014, with mortality follow-up through January 31, 2015). We included individuals aged 65 years and older (n= 96,481). We estimated mean QALY throughout the remainder of the lifetime according to the occurrence of these conditions. Results: The age-adjusted QALY was 5.8 years for men and 7.8 years for women. Over 90% respondents reported at least 1 condition and 72% reported multiple conditions. Respondents with depression and congestive heart failure had the lowest age-adjusted QALY (1.1-1.5 y for men and 1.5-2.2 y for women), whereas those with hypertension, arthritis, and sciatica had higher QALY (4.2-5.4 and 6.4-7.2 y, respectively). Having either depression or congestive heart failure and any 1 or 2 of the other 13 conditions was associated with the lowest QALY among the possible dyads and triads of chronic conditions. Dyads and triads with hypertension or arthritis were more prevalent, but had higher QALY. Conclusions: Understanding the burden of disease for common chronic conditions and for combinations of these conditions is useful for delivering high-quality primary care that could be tailored for individuals with combinations of chronic conditions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 740-746 |
| Number of pages | 7 |
| Journal | Medical Care |
| Volume | 56 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2018 |
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Keywords
- Burden of disease
- Chronic conditions
- Health-related quality of life (HRQOL)
- Quality-adjusted life year (QALY)
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
Cite this
Quality-adjusted life years (QALY) for 15 chronic conditions and combinations of conditions among US adults aged 65 and older. / Jia, Haomiao; Lubetkin, Erica I.; Barile, John P.; Horner-Johnson, Willi; DeMichele, Kimberly; Stark, Debra S.; Zack, Matthew M.; Thompson, William W.
In: Medical Care, Vol. 56, No. 8, 01.08.2018, p. 740-746.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Quality-adjusted life years (QALY) for 15 chronic conditions and combinations of conditions among US adults aged 65 and older
AU - Jia, Haomiao
AU - Lubetkin, Erica I.
AU - Barile, John P.
AU - Horner-Johnson, Willi
AU - DeMichele, Kimberly
AU - Stark, Debra S.
AU - Zack, Matthew M.
AU - Thompson, William W.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: Although the life expectancy for the US population has increased, a high proportion of this population has lived with =1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for older US adults. Research Design: Data were from the Medicare Health Outcomes Survey Cohort 15 (baseline survey in 2012, follow-up survey 2014, with mortality follow-up through January 31, 2015). We included individuals aged 65 years and older (n= 96,481). We estimated mean QALY throughout the remainder of the lifetime according to the occurrence of these conditions. Results: The age-adjusted QALY was 5.8 years for men and 7.8 years for women. Over 90% respondents reported at least 1 condition and 72% reported multiple conditions. Respondents with depression and congestive heart failure had the lowest age-adjusted QALY (1.1-1.5 y for men and 1.5-2.2 y for women), whereas those with hypertension, arthritis, and sciatica had higher QALY (4.2-5.4 and 6.4-7.2 y, respectively). Having either depression or congestive heart failure and any 1 or 2 of the other 13 conditions was associated with the lowest QALY among the possible dyads and triads of chronic conditions. Dyads and triads with hypertension or arthritis were more prevalent, but had higher QALY. Conclusions: Understanding the burden of disease for common chronic conditions and for combinations of these conditions is useful for delivering high-quality primary care that could be tailored for individuals with combinations of chronic conditions.
AB - Background: Although the life expectancy for the US population has increased, a high proportion of this population has lived with =1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for older US adults. Research Design: Data were from the Medicare Health Outcomes Survey Cohort 15 (baseline survey in 2012, follow-up survey 2014, with mortality follow-up through January 31, 2015). We included individuals aged 65 years and older (n= 96,481). We estimated mean QALY throughout the remainder of the lifetime according to the occurrence of these conditions. Results: The age-adjusted QALY was 5.8 years for men and 7.8 years for women. Over 90% respondents reported at least 1 condition and 72% reported multiple conditions. Respondents with depression and congestive heart failure had the lowest age-adjusted QALY (1.1-1.5 y for men and 1.5-2.2 y for women), whereas those with hypertension, arthritis, and sciatica had higher QALY (4.2-5.4 and 6.4-7.2 y, respectively). Having either depression or congestive heart failure and any 1 or 2 of the other 13 conditions was associated with the lowest QALY among the possible dyads and triads of chronic conditions. Dyads and triads with hypertension or arthritis were more prevalent, but had higher QALY. Conclusions: Understanding the burden of disease for common chronic conditions and for combinations of these conditions is useful for delivering high-quality primary care that could be tailored for individuals with combinations of chronic conditions.
KW - Burden of disease
KW - Chronic conditions
KW - Health-related quality of life (HRQOL)
KW - Quality-adjusted life year (QALY)
UR - http://www.scopus.com/inward/record.url?scp=85049160194&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049160194&partnerID=8YFLogxK
U2 - 10.1097/MLR.0000000000000943
DO - 10.1097/MLR.0000000000000943
M3 - Article
C2 - 29939910
AN - SCOPUS:85049160194
VL - 56
SP - 740
EP - 746
JO - Medical Care
JF - Medical Care
SN - 0025-7079
IS - 8
ER -