Family Spillover Effects on Health-Related Quality of Life (HRQOL)

Faculty Contact: Lisa A. Prosser, PhD

Background:
There is growing evidence that the effects of illness extend beyond the individual patient to include caregivers of patients, parents of ill children, and individuals in the immediate proximity of those with certain illnesses, including family and household members. These findings suggest that measurements of the health-related quality of life (HRQOL) associated with an illness or condition should also assess the effects specific to those surrounding individuals who may be affected. This research will estimate these "spillover" effects of illness on the health-related quality of life of individuals surrounding the affected patient, and how they may differ depending on the relationship to the ill individual and depending on the nature of the health condition.

Specific aims for this project are as follows:

  1. To estimate the effect of chronic and acute conditions on the health-related quality of life of individuals living in the same household;
  2. To estimate the effect of childhood chronic and acute conditions on the health-related quality of life of parents of these children;
  3. To estimate the effect of adult chronic and acute conditions on the health-related quality of life of caregivers of these individuals.

Methods:
Recognizing the divergence of HRQOL estimates based on population surveyed and assessment method or technique, multiple data sources and methodologies will be employed to estimate HRQOL as specified in these Aims. HRQOL will be estimated for the individual with illness and a designated "secondary" person, e.g., parents, caregivers and household members. Primary data will be collected from these pairs for acute and chronic conditions, using multiple direct and indirect assessment techniques and including both qualitative and quantitative data to fully elucidate the factors affecting HRQOL in the secondary individual. Separately, secondary data from large, national datasets will be used to derive population estimates for these effects, providing better estimation but lesser variation in estimation techniques. The distinction between "patient" and "community" values as applied in cost effectiveness analysis will be explored with our data, to elucidate the distinction between these perspectives in spillover effects as is already documented in individuals' HRQOL.

Implications for Health Policy:
The proposed study will advance the methodology of HRQOL measurement, as well as provide empiric findings on the dispersion of illnesses' effect on HRQOL beyond the immediately affected individual. The inclusion of spillover effects would expand the current view of health-related quality of life used in cost-effectiveness and cost-utility analysis to include family or household effects of illness, and would have implications for cost-effectiveness ratios and other outcome measures used in these analyses.

Funded by the National Institute of Nursing Research

For more information, please contact:
Investigator: Lisa A. Prosser, PhD
University of Michigan Child Health Evaluation and Research (CHEAR) Unit
300 North Ingalls, Rm 6A14
Ann Arbor, MI 48109-5456
Telephone: (734) 232-1077 Fax: (734) 936-0941
Email: lisapros[at]med.umich[dot]edu