LONG-TERM-CARE RESIDENTS PREFERENCES FOR HEALTH STATES ON THE QUALITYOF WELL-BEING SCALE

The Quality of Well-Being Scale (QWB) quantifies health-related qualit y of life with a single number that represents community-based prefere nces for combinations of symptom/problem complexes, mobility, physical activity, and social activity. The aim of this study was to compare p references of a long-term care population with those of the general po pulation, determine whether preferences vary by the age of the hypothe tical (target) person depicted in the health-state case description, a nd derive weights for new symptom/problem complexes of particular rele vance to frail, older individuals. A sample of 38 female and 12 male l ong-term care residents with an average age of 86 years was asked to r ate health-state scenarios that combined the four health domains of th e QWB. This sample rated quality of life 0.10 units lower on average ( on a 0-1 scale) than did the general population sample from which the QWB preferences were originally developed. Ratings of the same health state for younger versus older target persons did not differ significa ntly (all p values > 0.05 for t statistics). Weights derived for 11 ne w symptom/problem complexes were: disturbed sleep (-0.252), sit-to-sta nd requires maximal effort (-0.259), lonely (-0.265), walking a short distance causes extreme fatigue (-0.273), agitated (-0.284), hallucina ting (-0.355), incontinent (-0.359), unable to control one's behavior (-0.360), urinary catheter (-0.374), restrained in bed or chair (-0.37 4), and feeding tube through the nose or stomach (-0.402). These new w eights increase the relevance of the QWB for cost-utility evaluations of health interventions for long-term care residents.