TY - JOUR AU - Stewart,Susan T. AU - Woodward,Rebecca M. AU - Rosen,Allison B. AU - Cutler,David M. TI - A Proposed Method for Monitoring U.S. Population Health: Linking Symptoms, Impairments, and Health Ratings JF - National Bureau of Economic Research Working Paper Series VL - No. 11358 PY - 2005 Y2 - May 2005 UR - http://www.nber.org/papers/w11358 L1 - http://www.nber.org/papers/w11358.pdf N1 - Author contact info: Susan Stewart Harvard Interfaculty Program for Health Systems Improvement c/o NBER 1050 Massachusetts Ave Cambridge MA 02134 E-Mail: sstewart@nber.org Rebecca Woodward E-Mail: rwoodwar@nber.org Allison B. Rosen Department of Quantitative Health Sciences University of Massachusetts Medical School 55 Lake Avenue North, AC7-057 Worcester, MA 01655 Tel: (508)856-3548 Fax: (508)856-8993 E-Mail: allison.rosen@umassmed.edu David M. Cutler Department of Economics Harvard University 1875 Cambridge Street Cambridge, MA 02138 Tel: 617/496-5216 Fax: 617/496-8951 E-Mail: dcutler@harvard.edu AB - We propose a method of quantifying non-fatal health on a 0-1 QALY scale that details the impact of specific symptoms and impairments and is not based on ratings of counterfactual scenarios. Measures of general health status are regressed on health impairments and symptoms in different domains, using ordered probit and ordinary least squares regression. This yields estimates of their effects analogous to disutility weights, and accounts for complex non-additive relationships. Health measures used include self-rated health status on a 5-point scale, EuroQol 5D (EQ-5D) scores, and ratings of current health using a 0-100 rating scale and a time-tradeoff. Data are from the nationally representative Medical Expenditure Panel Survey (MEPS) year 2002 (N=34,615), with validation in an independent sample from MEPS 2000 (N=21,067) and among 1420 adults age 45-89 in the Beaver Dam Health Outcomes Study. Decrement weights for symptoms and impairments are used to derive estimates of overall health-related quality of life, laying the groundwork for a detailed national summary measure of health. To purchase a copy of the earlier version of this paper, please contact the Working Papers department directly at (617) 588 1405. ER -