John A Nyman1, Nathan A Barleen, Phatta Kirdruang. 1. Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455-0392, USA. nyman001@umn.edu
Abstract
BACKGROUND: A number of studies have estimated the quality-adjusted life years (QALYs) lost from nonfatal motor vehicle accident injuries, but these estimates have a number of limitations. OBJECTIVE: The goal of this study is to estimate the QALYs lost from the typical motor vehicle accident injury based on 1) data obtained through a standard preference elicitation procedure, 2) both permanent and nonpermanent injuries, and 3) a more realistic baseline quality-of-life level from which to determine the QALY decrement. This study also intends to demonstrate the advantages of using self-reported health status as the basis for determining a change in QALYs. RESEARCH DESIGN: Ordered probit equations were estimated to determine the change in self-reported health status associated with 3 categories of injuries. These results were next converted to their marginal effects and weighted by the quality-of-life estimates for self-reported health status found in Nyman and others (2007). The quality-of-life decrements for the 3 categories of injury were then converted to QALY decrements by applying estimates of the duration of that injury type. SUBJECTS: The data came from 8 years of the Medical Expenditure Panel Survey (MEPS), from 1997 to 2004. MEASURES: Self-reported health status categories were excellent, very good, good, fair, or poor. RESULTS: The reference case decrement for an average motor vehicle accident injury is 0.0612 QALYs or 0.0360 QALYs, if discounted at 3%. CONCLUSIONS: Quality-of-life weights for self-reported health status can be used to exploit the data in large national surveys.
BACKGROUND: A number of studies have estimated the quality-adjusted life years (QALYs) lost from nonfatal motor vehicle accident injuries, but these estimates have a number of limitations. OBJECTIVE: The goal of this study is to estimate the QALYs lost from the typical motor vehicle accident injury based on 1) data obtained through a standard preference elicitation procedure, 2) both permanent and nonpermanent injuries, and 3) a more realistic baseline quality-of-life level from which to determine the QALY decrement. This study also intends to demonstrate the advantages of using self-reported health status as the basis for determining a change in QALYs. RESEARCH DESIGN: Ordered probit equations were estimated to determine the change in self-reported health status associated with 3 categories of injuries. These results were next converted to their marginal effects and weighted by the quality-of-life estimates for self-reported health status found in Nyman and others (2007). The quality-of-life decrements for the 3 categories of injury were then converted to QALY decrements by applying estimates of the duration of that injury type. SUBJECTS: The data came from 8 years of the Medical Expenditure Panel Survey (MEPS), from 1997 to 2004. MEASURES: Self-reported health status categories were excellent, very good, good, fair, or poor. RESULTS: The reference case decrement for an average motor vehicle accident injury is 0.0612 QALYs or 0.0360 QALYs, if discounted at 3%. CONCLUSIONS: Quality-of-life weights for self-reported health status can be used to exploit the data in large national surveys.