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At least 19 recordsLinked to original sources
PubMed1976

Constructing social metrics for health status indexes.

Health status indexes used to make collective decisions satisfying the principles of equality and social minimum must incorporate a social metric for health. Any index or indicator applied to populations for determining health status or to health programs for evaluating outcome must confront the question of who prefers which states of health under which circumstances? Utility models, psychometric scaling, and empirical social decision valuation have been used to measure preferences for states of health. Efforts should be directed toward constructing social metrics for health that are prospective, context-independent, relevant, community-wide, ratio scalled, sensitive, empirically validated, and applicable to program evaluation. These efforts represent the application of normative social theory to research, an important advance in uncovering the mysteries of social action and its consequences.

Attitude to Health↗
PubMed1983

A Canadian Indian Health Status Index.

Health care services for registered "band" Indians in Ontario are provided primarily by the Canadian Federal Government. Complex management methods preclude the direct involvement of Indian people in the decisions for their health resource allocation. Health indicators, need, and health status indexes are reviewed. The biostatistics of mortality and demography of the Indian and reference populations are aggregated with hospitalization/morbidity experience as the Chen G'1 Index, as an indicator of normative and comparative need. This is weighted by linear measurements of perceived need for preventive medicine programs, as ranked and scaled values of priorities, Zj. These were determined by community survey on 11 Indian reserves using a non-probabilistic psychometric method of "pair comparisons," based upon "Thurstone's Law of Comparative Judgement.," The calculation of the aggregate single unit Indian Health Status Index [Log.G'1].Zj and its potential application in a "zero-base" budget is described.

Actuarial Analysis↗
PubMed1995

Health status and occupation: use of a health status index to measure the health of occupations.

A total of 4466 employed persons completed the short Auckland University Health Status Index (AUHSI) questionnaire and a health score was assigned to each individual on the basis of their responses. This health score was found to have statistically significant associations with a number of health-related measures, including socio-economic status (P < 0.001), and with occupational group: administrative, clerical/sales/service, skilled trades and unskilled labour (P < 0.001). Within the occupational groups, 3361 employees could be assigned to 42 specific occupations having 19 or more members each. After controlling for age and gender, significant differences in mean health score for specific occupation were found in the clerical/sales/service (P < 0.05), skilled trades (P = 0.002) and unskilled manual (P < 0.05) groups. It is postulated that these differences may be due to the nature of the specific occupation. Some possible reasons are listed. It is concluded that a global measure of health status such as this may be useful in the planning and evaluation of occupational health services.

Female↗
PubMed1977

The design and use of a health status index for family physicians.

This paper describes a Health Status Index (HSI) which is part of a patient encounter form in a family practice center. The Index, which is used to profile a patient's health status longitudinally, combines physical and psychosocial measures of health. Based on its use in the center and through the presentation of data on patient health status, the authors illustrate how the Index can facilitate the evaluation of care and the management of practice. More specifically, they suggest that such data assist physicians in: (1) evaluating the effect of different modes of treatment on the duration and severity of ill-defined symptoms and complaints; (2) identifying high-risk patients for special attention; (3) indicating treatment modalities which produce more desirable outcomes; (4) determining the efficiency of different modes of treatment and of continued care; and (5) addressing chronological, as well as interpersonal and interprofessional, questions of providing continuous care for the chronically ill.

Acute Disease↗
PubMed1975

A review of the research on general health status indexes.

During the mid-1960's, recognition of the spiraling cost of health care motivated Congress to enact several major pieces of legislation designed to underwrite efforts to improve the delivery of health services. The increased level of federal fiscal participation in the health service system has forced greater consciousness of the need for better accountability of the effectiveness and efficiency of the allocation of the dollar. Demands were articulated for precision tools which could evaluate the imput to output linkage between need and response; however, the tools were nascent and had limited applicability. Cost-effectiveness and cost-benefit analysis are two procedures that have since been applied with varying levels of success. A third tool, also developed as an outgrowth of the desire for a more accurate characterization of the planning concerns of an efficient/effective health service system, is the general health status index. The purpose of this article is to provide the reader with a comprehensive review of the literature on general health status indexes. Common objectives and constraints are presented, as well as a discussion of the expanding role of general health status indexes.

Activities of Daily Living↗
PubMed1985

A children's oral health status index based on dentists' judgment.

The children's oral health status index was developed as an integrated measure for the direct appraisal of pediatric patient populations in private practices, dental clinics, or school programs. The index is derived from a paired preference experiment with five pedodontists and five general dentists acting as judges of oral health in 200 case comparisons. Four easily measured variables are united numerically by the index: decayed teeth, occlusion, tooth position, and missing teeth (which have not been exfoliated). Clinical applications of the index in three geographic areas have all had good results.

Adolescent↗
PubMed2000

An empirical test of the validity of the Oral Health Status Index (OHSI) on a minority population.

Disease varies in different populations based on sociodemographic variables, and there is limited understanding of this interaction. The purpose of this methodological study was to determine the validity of the Oral Health Status Index, a disease-based index, on a Hispanic population by comparing it with the NIDCR epidemiological measures of disease, with the addition of demographic and behavioral variables. The epidemiologic data were collected according to the criteria defined by the NIDCR, including: a modified Decayed Missing Filled Surfaces Index, gingival inflammation, calculus, and destructive periodontal disease measures. The demographic and behavioral variables were gathered from 240 interviews with Hispanic adults in two community clinics. Bivariate analysis was used to determine relationships between the descriptive epidemiologic, demographic, and behavioral variables and the Oral Health Status Index (OHSI). There were statistically significant differences (p < 0.05) in mean OHSI scores among the demographic variables age, education, income, and place of birth; and the behavioral variables alcohol consumption, flossing, and acculturation. Multiple regression analysis with the OHSI as the dependent variable showed that the statistically significant (p < 0.001) epidemiologic predictors were: percentage of Decayed Teeth/Decayed, Filled Teeth; Number of Replaced Teeth/Missing Teeth; and millimeters of mesial attachment loss. These collectively explained 47.49% of the variance in the regression. The addition of demographic variables to the epidemiologic regression identified age (p < 0.05), gender (p < 0.01), and place of birth (p < 0.01) as significant predictors that explained an additional 4.12% of the variance, collectively bringing the total explained variance to 51.61%. The behavioral variables did not contribute significantly to predicting the OHSI regression score. The Oral Health Status Index in this study is validated by its correlation with both the epidemiologic measures and the demographic variables. This combination of variables separated the Hispanics into Mexicans and Central/South Americans.

Acculturation↗
PubMedDate not supplied

Validation of the children's Oral Health Status Index (COHSI).

The findings presented here provide support for the validity of the Children's Oral Health Status Index. The COHSI is a good predictor of dentists' ranking of the oral health of pairs of children when there are at least ten points difference between the scores.

Adolescent↗
PubMed1976

Toward a utility theory foundation for health status index models.

The axioms of utility theory are restated in terms of health outcomes, and some additional assumptions, consistent with the assumptions implicit in health status index models, are adduced to develop a consistent theory of the utility of health states. On the basis of the axioms and specific assumptions, techniques for measuring the health utility functions of individuals are described, and it is shown how these axioms and assumptions may be used to determine the utility to the individual of health programs that will affect him in various ways.

Health↗
PubMed1996

Health status index models for use in resource allocation decisions. A critical review in the light of observed preferences for social choice.

In the last two decades a number of health status index models have been developed for assessing the value of health outcomes in terms of quality-adjusted life years. The models can be tested by comparing their implications with direct observations of how societies think resources should be distributed across patient groups. This paper reviews empirical evidence of this kind from various countries and summarizes the evidence in three rules of thumb for selecting values for health states. Nine different models are judged relative to these rules of thumb. Eight of the models underestimate the strength of social preferences for treating the severely ill before the less severely ill. The ninth has a strong bias against states associated with emotional distress. As a consequence, none of the models can be seen as sufficient stand-alone instruments for valuing health outcomes. Instead, the models may be seen as complementary and adjustable parts of a tool kit that should also include the rules of thumb suggested in this paper.

Bias↗
PubMed1975

Successive intervals analysis of preference measures in a health status index.

The method of successive intervals, a procedure for obtaining equal intervals from category data, is applied to social preference data for a health status index. Several innovations are employed, including an approximate analysis of variance test for determining whether the intervals are of equal width, a regression model for estimating the width of the end intervals in finite scales, and a transformation to equalize interval widths and estimate item locations on the new scale. A computer program has been developed to process large data sets with a larger number of categories than previous programs.

Computers↗
PubMed1976

The mortality component of health status indexes.

The mortality component of contemporary health indexes is discussed. Since these indexes reduce to mortality indexes when only life and death states enter the analysis, they share the conceptual weaknesses of mortality indexes. Also, they do not incorporate consumption variables explicity and therefore provide no structure for relating health status and living standard. Some attention is devoted to methodological problems of assessing survival probabilities, either from survey or experimental data or from beliefs of experts or individuals who are affected directly. The final section deals with individual preferences for survival lotteries. Conceptual weaknesses of common indexes are discussed, several canonical models for survival preferences are presented, the interdependence of individual utilities is discussed, and methods for eliciting individual survival preferences are considered, along with some illustrative empirical results.

Choice Behavior↗
PubMed1979

Health status index: category rating versus magnitude estimation for measuring levels of well-being.

Levels of Well-Being are social preferences, or weights that members of society associate with time-specific states of function. A Weighted Life Expectancy, which can be used to measure program outputs, is created by summing the levels across diverse cases and multiplying them by probable transitions (prognoses) among the states and levels. This operation requires however, that the Levels of Well-Being be measured on underlying metric scale. The present analysis compares preference measurements from a simple category rating procedure with those obtained using the more complex and difficult magnitude estimation method which has been claimed to yield ratio level measures. In a randomly counterbalanced design, 65 college students rated 30 case descriptions representing the range of the Well-Being continuum. The results exhibit the classical logarithmic relation observed for a prothetic continua. When transformed to a meaningful 0-1 unit scale, however, the magnitude responses are compressed at the lower end of the scale near death. Such results are inconsistent not only with category rating, but also with intuitive notions of the relative importance of the function states, with the results of rating procedures that simulate social choice, and with evidence that confirms the interval properties of the category ratings themselves. Furthermore, the ease of administration of category rating means that multiple attributes of cases can be considered jointly, avoiding the need to aggregate scale values for different attributes by arbitrary rules. In sum, magnitude estimation is inappropriate as a measurement method for a Health Status Index and is probably also inappropriate for other measures of utility and social choice.

Activities of Daily Living↗
PubMed1997

Valuing morbidity: an integration of the willingness-to-pay and health-status index literatures.

Placing dollar values on human health has long been a controversial aspect of policy analysis and remains difficult given the relatively small number of morbidity-valuation studies available. By combining both the economic and health literature, this paper offers an alternative approach to morbidity valuation and provides estimates for a wide range of short-term health conditions.

Activities of Daily Living↗