Do established health-related quality-of-life measures adequately capture the impact of chronic conditions on subjective well-being?

Objectives: The paper explores how two well-established, utility-based health-related quality-of-life (HRQoL) measures (EQ-5D and 15D) capture the negative effects of various chronic conditions on subjective well-being (SWB). This is important, as both SWB and health utility can be important aims of health policy and instruments in resource allocation. Methods: A general population survey representing the Finnish population aged 30 years and over covering 25 self-reported somatic conditions and four psychiatric disorders diagnosed by interviews. Results: Both EQ-5D and 15D fail to capture the effects of some chronic conditions on SWB, but the conditions differ between the instruments. Even after controlling for both EQ-5D and 15D simultaneously, common psychiatric disorders decrease SWB by 0.4 points on a scale 1-10. Conclusions: Using health utility as a basis for resource allocation is likely to underfund the treatment of psychiatric disorders, in comparison to their effect on the SWB of the population. Different HRQoL instruments yield somewhat different results for different conditions.