IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v213y2018icp154-164.html
   My bibliography  Save this article

Using path analysis to investigate the relationships between standardized instruments that measure health-related quality of life, capability wellbeing and subjective wellbeing: An application in the context of spinal cord injury

Author

Listed:
  • Engel, Lidia
  • Bryan, Stirling
  • Noonan, Vanessa K.
  • Whitehurst, David G.T.

Abstract

While economic evaluations typically embrace health maximization as the maximization objective using quality-adjusted life years, there is increasing interest in the measurement of capability wellbeing and subjective wellbeing (SWB) for informing policy decisions. The objective of this study was to investigate the relationships between health-related quality of life (HRQoL), capability wellbeing and SWB. Data were used from 364 individuals living with spinal cord injury (SCI) who previously completed a web-based, cross-sectional survey (March–June 2013). Regression analyses were used to study the impacts of secondary health conditions on HRQoL, capability wellbeing and SWB; subsequently, a path analysis was used to assess direct and mediated pathways. HRQoL was measured using the EQ-5D-5L and the Assessment of Quality of Life 8-dimension (AQoL-8D) questionnaire; capability wellbeing was assessed using the ICEpop CAPability measure for Adults (ICECAP-A), and SWB was based on a single life satisfaction item (0–10 rating scale). Mean scores were 0.492, 0.573, 0.761 and 6.319 for EQ-5D-5L, AQoL-8D, ICECAP-A and SWB, respectively. Beta coefficients from the regression analyses indicated that secondary health conditions had the greatest negative impact on individuals' HRQoL (βAQoL-8D = −0.668, βEQ-5D-5L = −0.542), followed by SWB (βSWB = −0.481) and capability wellbeing (βICECAP-A = −0.477). Capability wellbeing mediated the effect of secondary health conditions on HRQoL and SWB. The indirect effect of secondary health conditions on SWB through HRQoL was not statistically significant when using EQ-5D-5L; indirect effects were found when using AQoL-8D, one through HRQoL only and one through both capability wellbeing and HRQoL. This study highlights the different impacts of secondary health conditions on HRQoL, capability and SWB in the context of SCI. While the greatest impact was observed on individuals' HRQoL, our results provide further evidence that capability wellbeing (here, the ICECAP-A) adds complementary information about outcomes that could be used in economic evaluation.

Suggested Citation

  • Engel, Lidia & Bryan, Stirling & Noonan, Vanessa K. & Whitehurst, David G.T., 2018. "Using path analysis to investigate the relationships between standardized instruments that measure health-related quality of life, capability wellbeing and subjective wellbeing: An application in the ," Social Science & Medicine, Elsevier, vol. 213(C), pages 154-164.
    • Handle: RePEc:eee:socmed:v:213:y:2018:i:c:p:154-164
    DOI: 10.1016/j.socscimed.2018.07.041
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953618304088
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2018.07.041?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Paul Anand & Graham Hunter & Ron Smith, 2005. "Capabilities and Well-Being: Evidence Based on the Sen–Nussbaum Approach to Welfare," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 74(1), pages 9-55, October.
    2. Daniel Kahneman & Robert Sugden, 2005. "Experienced Utility as a Standard of Policy Evaluation," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 32(1), pages 161-181, September.
    3. Cubi-Molla, P. & De Vries, J. & Devlin, N., 2013. "A Study of the Relationship Between Health and Subjective Well-being in Parkinson’s Disease Patients," Working Papers 13/12, Department of Economics, City University London.
    4. Brazier, John & Roberts, Jennifer & Deverill, Mark, 2002. "The estimation of a preference-based measure of health from the SF-36," Journal of Health Economics, Elsevier, vol. 21(2), pages 271-292, March.
    5. Paul Dolan & Daniel Kahneman, 2008. "Interpretations Of Utility And Their Implications For The Valuation Of Health," Economic Journal, Royal Economic Society, vol. 118(525), pages 215-234, January.
    6. Paula Lorgelly, 2015. "Choice of Outcome Measure in an Economic Evaluation: A Potential Role for the Capability Approach," PharmacoEconomics, Springer, vol. 33(8), pages 849-855, August.
    7. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 34-58, Spring.
    8. Coast, Joanna & Smith, Richard D. & Lorgelly, Paula, 2008. "Welfarism, extra-welfarism and capability: The spread of ideas in health economics," Social Science & Medicine, Elsevier, vol. 67(7), pages 1190-1198, October.
    9. Paul Dolan & Henry Lee & Tessa Peasgood, 2012. "Losing Sight of the Wood for the Trees," PharmacoEconomics, Springer, vol. 30(11), pages 1035-1049, November.
    10. Jeff Richardson & Gang Chen & Munir A. Khan & Angelo Iezzi, 2015. "Can Multi-attribute Utility Instruments Adequately Account for Subjective Well-being?," Medical Decision Making, , vol. 35(3), pages 292-304, April.
    11. Lidia Engel & Duncan Mortimer & Stirling Bryan & Scott A. Lear & David G. T. Whitehurst, 2017. "An Investigation of the Overlap Between the ICECAP-A and Five Preference-Based Health-Related Quality of Life Instruments," PharmacoEconomics, Springer, vol. 35(7), pages 741-753, July.
    12. Terry N. Flynn & Elisabeth Huynh & Tim J. Peters & Hareth Al‐Janabi & Sam Clemens & Alison Moody & Joanna Coast, 2015. "Scoring the Icecap‐a Capability Instrument. Estimation of a UK General Population Tariff," Health Economics, John Wiley & Sons, Ltd., vol. 24(3), pages 258-269, March.
    13. Versteegh, M.M. & Brouwer, W.B.F., 2016. "Patient and general public preferences for health states: A call to reconsider current guidelines," Social Science & Medicine, Elsevier, vol. 165(C), pages 66-74.
    14. Mukuria, Clara & Brazier, John, 2013. "Valuing the EQ-5D and the SF-6D health states using subjective well-being: A secondary analysis of patient data," Social Science & Medicine, Elsevier, vol. 77(C), pages 97-105.
    15. Hareth Al‐Janabi, 2018. "Do capability and functioning differ? A study of U.K. survey responses," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 465-479, March.
    16. Grewal, Ini & Lewis, Jane & Flynn, Terry & Brown, Jackie & Bond, John & Coast, Joanna, 2006. "Developing attributes for a generic quality of life measure for older people: Preferences or capabilities?," Social Science & Medicine, Elsevier, vol. 62(8), pages 1891-1901, April.
    17. Joanna Coast & Richard Smith & Paula Lorgelly, 2008. "Should the capability approach be applied in Health Economics?," Health Economics, John Wiley & Sons, Ltd., vol. 17(6), pages 667-670, June.
    18. Philip Kinghorn, 2015. "Exploring Different Interpretations of the Capability Approach in a Health Care Context: Where Next?," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 16(4), pages 600-616, November.
    19. Paul Dolan & Daniel Kahneman, 2008. "Interpretations Of Utility And Their Implications For The Valuation Of Health," Economic Journal, Royal Economic Society, vol. 118(525), pages 215-234, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sebastian Himmler & Job Exel & Werner Brouwer, 2020. "Estimating the monetary value of health and capability well-being applying the well-being valuation approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1235-1244, November.
    2. Ryota Arai & Masashi Kiguchi & Michio Murakami, 2020. "A Quantitative Estimation of the Effects of Measures to Counter Climate Change on Well-Being: Focus on Non-Use of Air Conditioners as a Mitigation Measure in Japan," Sustainability, MDPI, vol. 12(20), pages 1-18, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mitchell, Paul Mark & Roberts, Tracy E. & Barton, Pelham M. & Coast, Joanna, 2015. "Assessing sufficient capability: A new approach to economic evaluation," Social Science & Medicine, Elsevier, vol. 139(C), pages 71-79.
    2. Dolan, Paul & Kavetsos, Georgios & Tsuchiya, Aki, 2013. "Sick but satisfied: The impact of life and health satisfaction on choice between health scenarios," Journal of Health Economics, Elsevier, vol. 32(4), pages 708-714.
    3. John Brazier & Donna Rowen & Milad Karimi & Tessa Peasgood & Aki Tsuchiya & Julie Ratcliffe, 2018. "Experience-based utility and own health state valuation for a health state classification system: why and how to do it," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 881-891, July.
    4. Mukuria, Clara & Brazier, John, 2013. "Valuing the EQ-5D and the SF-6D health states using subjective well-being: A secondary analysis of patient data," Social Science & Medicine, Elsevier, vol. 77(C), pages 97-105.
    5. Myles-Jay Linton & Paul Mark Mitchell & Hareth Al-Janabi & Michael Schlander & Jeff Richardson & Angelo Iezzi & Jasper Ubels & Joanna Coast, 2020. "Comparing the German Translation of the ICECAP-A Capability Wellbeing Measure to the Original English Version: Psychometric Properties across Healthy Samples and Seven Health Condition Groups," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 15(3), pages 651-673, July.
    6. Coast, Joanna & Smith, Richard D. & Lorgelly, Paula, 2008. "Welfarism, extra-welfarism and capability: The spread of ideas in health economics," Social Science & Medicine, Elsevier, vol. 67(7), pages 1190-1198, October.
    7. Magdalena Muszyńska-Spielauer & Marc Luy, 2022. "Well-Being Adjusted Health Expectancy: A New Summary Measure of Population Health," European Journal of Population, Springer;European Association for Population Studies, vol. 38(5), pages 1009-1031, December.
    8. Sarah Flèche & Richard Layard, 2017. "Do More of Those in Misery Suffer from Poverty, Unemployment or Mental Illness?," Kyklos, Wiley Blackwell, vol. 70(1), pages 27-41, February.
    9. Joanna Coast, 2019. "Assessing capability in economic evaluation: a life course approach?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 779-784, August.
    10. Cassandra Mah & Vanessa K. Noonan & Stirling Bryan & David G. T. Whitehurst, 2021. "Empirical Validity of a Generic, Preference-Based Capability Wellbeing Instrument (ICECAP-A) in the Context of Spinal Cord Injury," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(2), pages 223-240, March.
    11. Philip Kinghorn & Angela Robinson & Richard Smith, 2015. "Developing a Capability-Based Questionnaire for Assessing Well-Being in Patients with Chronic Pain," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 120(3), pages 897-916, February.
    12. Joanna Coast & Philip Kinghorn & Paul Mitchell, 2015. "The Development of Capability Measures in Health Economics: Opportunities, Challenges and Progress," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(2), pages 119-126, April.
    13. Sebastian Himmler & Job van Exel & Werner Brouwer, 2020. "Happy with Your Capabilities? Valuing ICECAP-O and ICECAP-A States Based on Experienced Utility Using Subjective Well-Being Data," Medical Decision Making, , vol. 40(4), pages 498-510, May.
    14. John Brazier & Jennifer Roberts & Donna Rowen, 2012. "Methods for Developing Preference-based Measures of Health," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 37, Edward Elgar Publishing.
    15. Wildman, John & McMeekin, Peter & Grieve, Eleanor & Briggs, Andrew, 2016. "Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators," Social Science & Medicine, Elsevier, vol. 169(C), pages 141-148.
    16. Paula Lorgelly, 2015. "Choice of Outcome Measure in an Economic Evaluation: A Potential Role for the Capability Approach," PharmacoEconomics, Springer, vol. 33(8), pages 849-855, August.
    17. Paul Mark Mitchell & Hareth Al-Janabi & Jeff Richardson & Angelo Iezzi & Joanna Coast, 2015. "The Relative Impacts of Disease on Health Status and Capability Wellbeing: A Multi-Country Study," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-15, December.
    18. Paul Mark Mitchell & Sridhar Venkatapuram & Jeff Richardson & Angelo Iezzi & Joanna Coast, 2017. "Are Quality-Adjusted Life Years a Good Proxy Measure of Individual Capabilities?," PharmacoEconomics, Springer, vol. 35(6), pages 637-646, June.
    19. Hernández-Alava, Mónica & Sampson, Christopher & Wailoo, Allan, 2013. "Happy and healthy: a joint model of health and life satisfaction," MPRA Paper 49766, University Library of Munich, Germany.
    20. Paul Mark Mitchell & Samantha Husbands & Sarah Byford & Philip Kinghorn & Cara Bailey & Tim J. Peters & Joanna Coast, 2021. "Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 1990-2003, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:213:y:2018:i:c:p:154-164. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.