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Measuring Family HRQoL Spillover Effects Using Direct Health Utility Assessment

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  • Lisa A. Prosser
  • Kara Lamarand
  • Acham Gebremariam
  • Eve Wittenberg

Abstract

Background. Applications of cost-effectiveness analysis do not typically incorporate effects on caregiver quality of life despite increasing evidence that these effects are measurable. Methods. Using a national sample of US adults, we conducted 2 cross-sectional surveys during December 2011 and January 2012. One version asked respondents to value their own experience as the family member of a person with a chronic illness (experienced sample), and the other version asked respondents to value hypothetical scenarios describing the experience of having a family member with a chronic illness (community sample). Conditions included Alzheimer’s disease/dementia, arthritis, cancer, and depression. Using standard gamble questions, respondents were asked to value the spillover effects of a family member’s illness. We used regression analysis to evaluate the disutility (loss in health-related quality of life) of having a family member with a chronic illness by condition and relationship type, controlling for the respondent’s own conditions and sociodemographic characteristics. Results. For the experienced sample ( n = 1389), regression analyses suggested that greater spillover was associated with certain conditions (arthritis, depression) compared with other conditions (Alzheimer’s disease, cancer). For the community sample ( n = 1205), regression analyses indicated that lower spillover was associated with condition (cancer) but not the type of relationship with the ill family member (parent, child, spouse). Conclusions. The effects of illness extend beyond the individual patient to include effects on caregivers of patients, parents of ill children, spouses, and other close family and household members. Cost-effectiveness analyses should consider the inclusion of health-related quality of life spillover effects in addition to caregiving time costs incurred by family members of ill individuals.

Suggested Citation

  • Lisa A. Prosser & Kara Lamarand & Acham Gebremariam & Eve Wittenberg, 2015. "Measuring Family HRQoL Spillover Effects Using Direct Health Utility Assessment," Medical Decision Making, , vol. 35(1), pages 81-93, January.
    • Handle: RePEc:sae:medema:v:35:y:2015:i:1:p:81-93
    DOI: 10.1177/0272989X14541328
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    References listed on IDEAS

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    1. Al-Janabi, Hareth & Coast, Joanna & Flynn, Terry N., 2008. "What do people value when they provide unpaid care for an older person? A meta-ethnography with interview follow-up," Social Science & Medicine, Elsevier, vol. 67(1), pages 111-121, July.
    2. Garber, Alan M. & Sculpher, Mark J., 2011. "Cost Effectiveness and Payment Policy," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 471-497, Elsevier.
    3. Tara Lavelle & Eve Wittenberg & Kara Lamarand & Lisa Prosser, 2014. "Variation in the Spillover Effects of Illness on Parents, Spouses, and Children of the Chronically Ill," Applied Health Economics and Health Policy, Springer, vol. 12(2), pages 117-124, April.
    4. Meltzer, David O. & Smith, Peter C., 2011. "Theoretical Issues Relevant to the Economic Evaluation of Health Technologies," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 433-469, Elsevier.
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    1. Hareth Al-Janabi & Andrea Manca & Joanna Coast, 2017. "Predicting carer health effects for use in economic evaluation," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-18, September.
    2. Ashley A. Leech & Pei-Jung Lin & Brittany D’Cruz & Susan K. Parsons & Tara A. Lavelle, 2023. "Family Spillover Effects: Are Economic Evaluations Misrepresenting the Value of Healthcare Interventions to Society?," Applied Health Economics and Health Policy, Springer, vol. 21(1), pages 5-10, January.

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