Abstract

Background

Utility scores are frequently used as preference weights when estimating quality-adjusted life years within cost-utility analyses or health-adjusted life expectancies. Though previous Canadian estimates for specific chronic conditions have been produced, these may no longer reflect current patient populations.

Data and methods

Data from the 2013 and 2014 Canadian Community Health Survey were used to provide Canadian utility score norms for 17 chronic conditions. Utility scores were estimated using the Health Utilities Index Mark 3 instrument and were reported as weighted average (95% confidence intervals [95% CI]) values. In addition to age- and sex-stratified analyses, results were also stratified according to the number of reported chronic conditions (i.e., “none” to “five or more”). All results were weighted using sampling and bootstrapped weights provided by Statistics Canada.

Results

Utility scores were estimated for 123,654 (97.2%) respondents (weighted frequency = 29,337,370 [97.7%]). Of the chronic conditions that were examined, asthma had the least detrimental effect (weighted average utility score = 0.803 [95% CI: 0.795 to 0.811]) on respondents’ utility scores, and Alzheimer’s disease or any other dementia had the most detrimental effect (weighted average utility score = 0.374 [95% CI: 0.323 to 0.426]). Respondents who reported suffering from no chronic conditions had, on average, the highest utility scores (weighted average utility score = 0.928 [95% CI: 0.926 to 0.930]). Estimates dropped as a function of the number of reported chronic conditions.

Interpretation

Utility scores differed between various chronic conditions and as a function of the number of reported chronic conditions. Results also highlighted several differences with previously published Canadian utility norms.

Keywords

Canada; Canadian Community Health Survey (CCHS); chronic disease; health status; Health Utilities Index Mark 3 (HUI3); multiple chronic conditions; utility scores

Findings

Health-related quality of life (HRQoL) has many definitions. One common definition for HRQoL within the health economic literature is the “values assigned to different health states.” Those values are also known as utility scores. By convention, a utility score of 1.00 is assigned to a perfect health state, and a utility score of 0.00 is assigned to a dead state. Health states considered worse than dead are assigned a negative value. [Full Text]

Authors

Jason R. Guertin is with the Department of Social and Preventive Medicine and the Centre de recherche du CHU de Québec at Université Laval, Québec, Quebec. Brittany Humphries and Jean-Eric Tarride are with the Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences at McMaster University, Hamilton, Ontario. David Feeny and Jean-Eric Tarride are with the Department of Economics and the Centre for Health Economics and Policy Analysis at McMaster University, Hamilton, Ontario. David Feeny is also with Health Utilities Incorporated, Dundas, Ontario, and Jean-Eric Tarride is also with Programs for Assessment of Technology in Health, the Research Institute of St. Joe’s Hamilton, St. Joseph’s Healthcare Hamilton, Ontario.

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