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Quality of Life and Time to Death

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  • Maria Gheorghe
  • Werner B. F. Brouwer
  • Pieter H. M. van Baal

Abstract

This article explores the implications of the relation between quality of life (QoL) and time to death (TTD) for economic evaluations of preventive interventions. By using health survey data on QoL for the general Dutch population linked to the mortality registry, we quantify the magnitude of this relationship. For addressing specific features of the nonstandard QoL distribution such as boundness, skewness, and heteroscedasticity, we modeled QoL using a generalized additive model for location, scale, and shape (GAMLSS) with a β inflated outcome distribution. Our empirical results indicate that QoL decreases when approaching death, suggesting that there is a strong relationship between TTD and QoL. Predictions of different regression models revealed that ignoring this relationship results in an underestimation of the quality-adjusted life year (QALY) gains for preventive interventions. The underestimation ranged between 3% and 7% and depended on age, the number of years gained from the intervention, and the discount rate used.

Suggested Citation

  • Maria Gheorghe & Werner B. F. Brouwer & Pieter H. M. van Baal, 2015. "Quality of Life and Time to Death," Medical Decision Making, , vol. 35(3), pages 316-327, April.
    • Handle: RePEc:sae:medema:v:35:y:2015:i:3:p:316-327
    DOI: 10.1177/0272989X14555771
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    References listed on IDEAS

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    2. Pieter van Baal & Meg Perry‐Duxbury & Pieter Bakx & Matthijs Versteegh & Eddy van Doorslaer & Werner Brouwer, 2019. "A cost‐effectiveness threshold based on the marginal returns of cardiovascular hospital spending," Health Economics, John Wiley & Sons, Ltd., vol. 28(1), pages 87-100, January.

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