Health utility attributes for chronic conditions

Objective: To determine the importance of specific health utility attribute s that comprise overall utility scores for a number of chronic health state conditions. Study design: Cross-sectional study using data from a prospective national survey of the health of community-dwelling Canadians. Study population: 47 534 individuals who answered both health questions and utility questions (51.8% male). Methods: The attributes making up the Health Utilities Index (HUI-Mark III) scores (i.e, vision, hearing, speech, ambulation, dexterity, emotion, cogn ition and pain) for 21 chronic conditions were examined from the National P opulation Health Survey (NPHS) 1996 to 1997. Conditions included Alzheimer' s disease, arthritis/rheumatism, asthma, back problems excluding arthritis, bowel disorder, chronic bronchitis or emphysema. cancer, cataracts, diabet es, epilepsy, food allergies, glaucoma, heart disease, hypertension, migrai ne headaches, other allergies, sinusitis, stroke, stomach/intestinal ulcers , thyroid conditions and urinary incontinence. HUI-Mark III scores for pati ents without an NPHS-defined chronic condition were also collected. All con ditions were mutually exclusive. Results: The mean HUI-Mark III score for patients without a chronic health state was 0.953 +/- 0.060. Individuals with Alzheimer's disease (0.846 +/- 0.168), stroke (0.869 +/- 0.163) and arthritis/rheumatism (0.883 +/- 0.132) had the lowest overall HUI-Mark III scores. Individuals with Alzheimer's d isease (28.6%), epilepsy (23.1%) and urinary incontinence (19.8%) reported higher scores on the emotional impairment attribute. Individuals with arthr itis/rheumatism (24.7%) and back problems (20.6%) had high levels of pain/d iscomfort. Patients with stroke (16.4%) had low mobility scores. Conclusion: By determining which attributes are important to chronic health conditions, this study provides health economists, researchers and policy makers with a reference of health state attributes for various chronic cond itions.