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Type: Journal article
Title: Health-Related Quality of Life (HRQoL) changes in South Australia: comparison of burden of disease morbidity and survey-based health utility estimates
Author: Banham, D.
Hawthorne, G.
Goldney, R.
Ratcliffe, J.
Citation: Health and Quality of Life Outcomes, 2014; 12(113):1-10
Publisher: BioMed Central
Issue Date: 2014
ISSN: 1477-7525
Statement of
David Banham, Graeme Hawthorne, Robert Goldney, and Julie Ratcliffe
Abstract: Background: Global research shows a clear transition in health outcomes over the past two decades where improved survival was accompanied by lower health related quality of life (HRQoL) as measured by morbidity and disability. These trends suggest the need to better understand changes in population HRQoL. This paper compares two perspectives on population HRQoL change using burden of disease morbidity estimates from administrative data and self-reports from random and representative population surveys. Methods: South Australian administrative data including inpatient hospital activity, cancer and communicable disease registrations were used within a Burden of Disease study framework to quantify morbidity as Prevalent Years of Life lived with Disease and injury related illness (PYLD) for 1999 to 2008. Self-reported HRQoL was measured using the Assessment of Quality of Life (AQoL) in face to face interviews with at least 3000 respondents in each of South Australia ’ s Health Omnibus Surveys (HOS) in 1998, 2004 and 2008. Results: Age specific PYLD rates for those aged 75 or more increased by 5.1%. HRQoL dis-utility in this age group also increased significantly and beyond the minimally important difference threshold. Underlying increased dis-utility were greater difficulties in independent living (particularly requiring help with household tasks) and psychological well-being (as influenced by pain, discomfort and difficulty sleeping). Conclusions: Consistent with increased quantity of life being accompanied by reduced HRQoL, the analysis indicates older people in South Australia experienced increased morbidity in the decade to 2008. The results warrant routine monitoring of health dis-utility at a population level and improvement to the supply and scope of administrative data.
Keywords: Health related quality of life; morbidity; population health; burden of disease; health utility; patient reported outcome measures; AQoL
Rights: © 2014 Banham et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
DOI: 10.1186/s12955-014-0113-4
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