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QALYs and mental health care
D Chisholm1, A Healey, M Knapp
1Centre for the Economics of Mental Health (CEMH), University of London, UK.
Social Psychiatry and Psychiatric Epidemiology
|February 1, 1997
Summary
Quality-adjusted life year (QALY) measures are debated for healthcare resource allocation. While useful, generic QALYs are insensitive to mental health care outcomes, risking marginalization of patients.
Area of Science:
- Health Economics
- Health Services Research
- Mental Health Policy
Background:
- Quality-adjusted life year (QALY) measures are widely used but debated in healthcare resource allocation.
- Concerns exist regarding the technical and ethical validity of QALYs, particularly in specialized care areas.
- Mental health care presents unique challenges for outcome measurement using generic QALYs.
Purpose of the Study:
- To examine the arguments surrounding QALYs in healthcare resource allocation.
- To specifically assess the strengths and shortcomings of QALYs within the context of mental health care.
- To explore the implications of QALY-driven priority setting for individuals with mental illnesses.
Main Methods:
- Review of existing literature and arguments concerning QALYs.
- Analysis of QALY application in general healthcare evaluation.
- Specific focus on the relevance and limitations of QALYs for mental health care outcomes.
Main Results:
- The underlying principles of utility measurement for QALYs are sound.
- Generic QALYs are currently an insensitive measure for the outcomes of mental health care.
- Abandoning QALYs in a QALY-driven environment risks marginalizing mental health patients.
Conclusions:
- A generic QALY is an insensitive measure for mental health care outcomes.
- Developing a mental-health specific utility measure is a potential solution.
- Such a measure, combined with cost data, could improve resource allocation for mental health services.