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Applied Health Economics and Health Policy
Published in: Applied Health Economics and Health Policy 3/2017

01-06-2017 | Original Research Article

An Empirical Comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a Post-Hospitalisation Population of Frail Older People Living in Residential Aged Care

Authors: Julie Ratcliffe, Thomas Flint, Tiffany Easton, Maggie Killington, Ian Cameron, Owen Davies, Craig Whitehead, Susan Kurrle, Michelle Miller, Enwu Liu, Maria Crotty

Published in: Applied Health Economics and Health Policy | Issue 3/2017

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Abstract

Objective

To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture.

Methods

A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks’ follow-up. Descriptive summary statistics were produced and psychometric analyses were conducted to assess the levels of agreement, convergent validity and known group validity between clinical indicators and HRQoL measures.

Results

There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5L and DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. At 4 weeks’ follow-up, there was a marked improvement in EQ-5D-5L scores whereas DEMQOL-U scores had deteriorated. [EQ-5D-5L mean 0.45 (0.38); DEMQOL-U mean 0.58 (0.38)]. The EQ-5D and CEQ-5D-5L were more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U appeared more responsive to the changes in delirium and dementia symptoms often experienced by frail older people in this period.

Conclusions

This study presents important insights into the HRQoL of a relatively under-researched population of post-hospitalisation frail older people in residential care. Further research should investigate the implications for economic evaluation of self-complete versus proxy assessment of HRQoL and the choice of preference-based instrument for the measurement and valuation of HRQoL in older people exhibiting cognitive decline, dementia and other co-morbidities.
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Metadata
Title
An Empirical Comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a Post-Hospitalisation Population of Frail Older People Living in Residential Aged Care
Authors
Julie Ratcliffe
Thomas Flint
Tiffany Easton
Maggie Killington
Ian Cameron
Owen Davies
Craig Whitehead
Susan Kurrle
Michelle Miller
Enwu Liu
Maria Crotty
Publication date
01-06-2017
Publisher
Springer International Publishing
Published in
Applied Health Economics and Health Policy / Issue 3/2017
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-016-0293-7

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