HRQL Impact of Chronic Conditions and Comorbidity Burden

[unreadable] DESCRIPTION (provided by applicant): As life expectancy has increased for the average American, attention is focused on improving health-related quality of life (HRQL). The burgeoning cost of medical care within the reality of limited societal resources has necessitated the use of cost-effectiveness methods to assess the value of competing health interventions for an aging population. Quality-adjusted life years (QALYs) rely on preference weights to adjust the HRQL of different health states: Preference weights are the cornerstone of the QALY method, and are integral to the appropriate use of cost-effectiveness analysis. The Panel on Cost-Effectiveness in Health and Medicine (PCEHM) has called for a catalogue of "off the shelf preference weights associated with conditions that could be used by health researchers to promote the comparability of cost-effectiveness analyses in the U.S., thereby enabling accurate assessment of the medical interventions with the most value for the treatment of chronic conditions in older populations. Sullivan et al. have developed a preliminary catalogue of preference weights for chronic conditions, incorporating a generic examination of comorbidity burden and age. The overall objective of the current application is to 1) increase the depth of the catalogue for select priority conditions affecting older adults by assessing more specifically the impact of age, chronic disease and comorbidity interactions and 2) increase the breadth of the catalogue by examining EQ-5D index scores associated with an additional 293 chronic ICD-9 codes. We plan to accomplish the overall objective of this application by linking several publicly available data files and pursuing the following specific aims in the resultant nationally representative sample of the U.S. population: 1) determine the most prevalent comorbidities associated with select chronic conditions impacting older adults; 2) assess the impact of chronic conditions, comorbidity interactions and age on preference-based HRQL scores for select chronic conditions impacting older adults and 3) develop preference weights for chronic ICD-9 codes in the U.S. [unreadable] [unreadable]