Search resultsHealth utility ratings for a spectrum of alcohol-related health states
Title
Health utility ratings for a spectrum of alcohol-related health states
Publication type
Journal Article
Year of Publication
2005
Authors
Journal
Medical Care
Volume
43
Issue
6
Pagination
541 - 550
Date published
2005
ISBN
00257079 (ISSN)
Keywords
Academic Medical Centers, Adult, Aged, Aged, 80 and over, alcohol, alcohol abuse, alcohol consumption, Alcohol Drinking, Alcohol-Related Disorders, Alcoholism, article, attitude to health, blindness, Boston, Child, community, comparative study, confidence interval, Cross-Sectional Studies, cross-sectional study, Death, disease severity, drinking, drinking behavior, Female, health care utilization, health status, human, Humans, Interview, Interviews, Linear Models, male, measurement, Middle Aged, outcomes research, pain assessment, Pain Measurement, pathophysiology, Pennsylvania, Preferences, Primary Health Care, Psychiatric Status Rating Scales, psychological aspect, psychological rating scale, questionnaire, Questionnaires, risk assessment, Sickness Impact Profile, statistical model, United States, university hospital, Utilities, Utility assessment, visual analog scale
Abstract
Background: Preference-based utility ratings for health conditions are important components of cost-utility analyses and population burden of disease estimates. However, utility ratings for alcohol problems have not been determined. Objectives: The objectives of this study were to directly measure utility ratings for a spectrum of alcohol-related health states and to compare different methods of utility measurement. Design, Setting, and Subjects: The authors conducted a cross-sectional interview of 200 adults from a clinic and community sample. Methods: Subjects completed computerized visual analog scale (VAS), time tradeoff (TTO), and standard gamble (SG) utility measurement exercises for their current health, a blindness scenario, and for 6 alcohol-related health state scenarios presented in random order. The main outcome measures were the utility ratings, scaled from 0 to 1, and anchored by death (0) and perfect health (1). Results: The 200 subjects were middle-aged (mean, 41 ± 14 years), 61% women, and racially diverse (48% black, 43% white). Utility ratings decreased as the severity of the alcohol-related health state increased, but differed significantly among the VAS, TTO, and SG methods within each health state. Adjusted mean (95% confidence interval) utility ratings for alcohol dependence (VAS, 0.38 [0.34-0.41]; TTO, 0.54 [0.48-0.60]; SG, 0.68 [0.63-0.73]) and alcohol abuse (VAS, 0.53 [0.49-0.56]; TTO, 0.71 [0.65-77]; SG, 0.76 [0.71-0.81]) were significantly lower than utility ratings for non-drinking, moderate drinking, at-risk drinking, current health, and blindness. Conclusions: Utility ratings for alcohol-related health states decrease as the severity of alcohol use increases. The low utility ratings for alcohol abuse and alcohol dependence are similar to those reported for other severe chronic medical conditions. Copyright