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Valuing the ICECAP capability index for older people


  • Coast, Joanna
  • Flynn, Terry N.
  • Natarajan, Lucy
  • Sproston, Kerry
  • Lewis, Jane
  • Louviere, Jordan J.
  • Peters, Tim J.


This paper reports the first application of the capabilities approach to the development and valuation of an instrument for use in the economic evaluation of health and social care interventions. The ICECAP index of capability for older people focuses on quality of life rather than health or other influences on quality of life, and is intended to be used in decision making across health and social care in the UK. The measure draws on previous qualitative work in which five conceptual attributes were developed: attachment, security, role, enjoyment and control. This paper details the innovative use within health economics of further iterative qualitative work in the UK among 19 informants to refine lay terminology for each of the attributes and levels of attributes used in the eventual index. For the first time within quality of life measurement for economic evaluation, a best-worst scaling exercise has been used to estimate general population values (albeit for the population of those aged 65+ years) for the levels of attributes, with values anchored at one for full capability and zero for no capability. Death was assumed to be a state in which there is no capability. The values obtained indicate that attachment is the attribute with greatest impact but all attributes contribute to the total estimation of capability. Values that were estimated are feasible for use in practical applications of the index to measure the impact of health and social care interventions.

Suggested Citation

  • Coast, Joanna & Flynn, Terry N. & Natarajan, Lucy & Sproston, Kerry & Lewis, Jane & Louviere, Jordan J. & Peters, Tim J., 2008. "Valuing the ICECAP capability index for older people," Social Science & Medicine, Elsevier, vol. 67(5), pages 874-882, September.
  • Handle: RePEc:eee:socmed:v:67:y:2008:i:5:p:874-882

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    References listed on IDEAS

    1. Flynn, Terry N. & Louviere, Jordan J. & Peters, Tim J. & Coast, Joanna, 2007. "Best-worst scaling: What it can do for health care research and how to do it," Journal of Health Economics, Elsevier, vol. 26(1), pages 171-189, January.
    2. Sabina Alkire, 2005. "Why the Capability Approach?," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 6(1), pages 115-135.
    3. Ingrid Robeyns, 2005. "The Capability Approach: a theoretical survey," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 6(1), pages 93-117.
    4. Anand, Paul & van Hees, Martin, 2006. "Capabilities and achievements: An empirical study," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 35(2), pages 268-284, April.
    5. Ingrid Robeyns, 2003. "Sen'S Capability Approach And Gender Inequality: Selecting Relevant Capabilities," Feminist Economics, Taylor & Francis Journals, vol. 9(2-3), pages 61-92.
    6. Carr-Hill, Roy A., 1989. "Assumptions of the QALY procedure," Social Science & Medicine, Elsevier, vol. 29(3), pages 469-477, January.
    7. 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.
    8. Glendinning, Caroline, 2003. "Breaking down barriers: integrating health and care services for older people in England," Health Policy, Elsevier, vol. 65(2), pages 139-151, August.
    9. Richard Cookson, 2005. "QALYs and the capability approach," Health Economics, John Wiley & Sons, Ltd., vol. 14(8), pages 817-829.
    10. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
    11. Martha Nussbaum, 2003. "Capabilities As Fundamental Entitlements: Sen And Social Justice," Feminist Economics, Taylor & Francis Journals, vol. 9(2-3), pages 33-59.
    12. Sudhir Anand and Amartya Sen, 1994. "Human development Index: Methodology and Measurement," Human Development Occasional Papers (1992-2007) HDOCPA-1994-02, Human Development Report Office (HDRO), United Nations Development Programme (UNDP).
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