Health Utility Attributes for Chronic Conditions

Objective To determine the importance of specific health utility attributes that comprise overall utility scores for a number of chronic health state conditions. Study design Cross-sectional study using data from a prospective national survey of the health of community-dwelling Canadians. Study population 47 534 individuals who answered both health questions and utility questions (51.8% male). Methods The attributes making up the Health Utilities Index (HUI-Mark III) scores (i.e. vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain) for 21 chronic conditions were examined from the National Population Health Survey (NPHS) 1996 to 1997. Conditions included Alzheimer’s disease, arthritis/rheumatism, asthma, back problems excluding arthritis, bowel disorder, chronic bronchitis or emphysema, cancer, cataracts, diabetes, epilepsy, food allergies, glaucoma, heart disease, hypertension, migraine headaches, other allergies, sinusitis, stroke, stomach/intestinal ulcers, thyroid conditions and urinary incontinence. HUI-Mark III scores for patients without an NPHS-defined chronic condition were also collected. All conditions were mutually exclusive. Results The mean HUI-Mark III score for patients without a chronic health state was 0.953 ± 0.060. Individuals with Alzheimer’s disease (0.846 ± 0.168), stroke (0.869 ± 0.163) and arthritis/rheumatism (0.883 ± 0.132) had the lowest overall HUI-Mark III scores. Individuals with Alzheimer’s disease (28.6%), epilepsy (23.1%) and urinary incontinence (19.8%) reported higher scores on the emotional impairment attribute. Individuals with arthritis/rheumatism (24.7%) and back problems (20.6%) had high levels of pain/discomfort. Patients with stroke (16.4%) had low mobility scores. Conclusion By determining which attributes are important to chronic health conditions, this study provides health economists, researchers and policy makers with a reference of health state attributes for various chronic conditions.