• S Cykert, J D Joines, G Kissling, and C J Hansen.
• Division of General Internal Medicine and Clinical Epidemiology of the University of North Carolina School of Medicine, Chapel Hill, USA.
• J Gen Intern Med. 1999 Apr 1; 14 (4): 217222217-22.

ObjectiveTo determine health utility scores for specific debilitated health states and to identify whether race or other demographic differences predict significant variation in these utility scores.DesignUtility analysis.SettingA community hospital general internal medicine clinic, a private internal medicine practice, and a private pulmonary medicine practice.ParticipantsSixty-four consecutive patients aged 50 to 75 years awaiting appointments. In order to participate, patients at the pulmonary clinic had to meet prespecified criteria of breathing impairment.MeasurementsIndividuals' strength of preference concerning specific states of limited physical function as measured by the standard gamble technique.Main ResultsMean utility scores used to quantitate limitations in physical function were extremely low. Using a scale for which 0 represented death and 1.0 represented normal health, limitation in activities of daily living was rated 0. 19 (95% confidence interval [CI] 0.13, 0.25), tolerance of only bed-to-chair ambulation 0.17 (95% CI 0.11, 0.23), and permanent nursing home placement 0.16 (95% CI 0.10, 0.22). Bivariate analysis identified female gender and African-American race as predictors of higher utility scores ( p ConclusionComparisons of African-American values with those of whites concerning defined states of debility demonstrate greater than threefold increases in utility scores. This finding suggests that racial differences need to be taken into account when studying the effects of medical interventions on quality of life.

21 keywords...

hide…