Developing attributes for a generic quality of life measure for older people: preferences or capabilities?

Grewal, Ini; Lewis, Jane; Flynn, Terry; Brown, Jackie; Bond, John; Coast, Joanna

doi:10.1016/j.socscimed.2005.08.023

Cited by 402Aging, Health, and DisabilityHealth Systems, Economic Evaluations, Quality of LifeAging, Elder Care, and Social Issues

Developing attributes for a generic quality of life measure for older people: preferences or capabilities?

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Grewal, Ini, Lewis, Jane, Flynn, Terry, Brown, Jackie, Bond, John, Coast, Joanna·2006·Social Science & Medicine

DOI 10.1016/j.socscimed.2005.08.023

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Abstract

Current UK policy with respect to the provision of health and social care for older people suggests that greater integration is required. Economists' attempts to assist resource allocation decisions, however, are very health focused, with concentration on the use of health-related quality of life measures. This paper reports an attempt to determine attributes for a new index clearly focusing on quality of life for older people rather than health or other influences on quality of life. In-depth interviews were conducted with 40 purposively selected informants aged 65 and over in private households to explore their views about what is important to them in terms of quality of life. Data were analysed using Framework qualitative analysis. Initial discussions tended to concentrate upon factors influencing quality of life including activities, relationships, health, wealth and surroundings. Further probing and analysis suggested five conceptual attributes: attachment, role, enjoyment, security and control. The data also suggested that the quality of informants' lives was limited by the loss of ability to pursue these attributes. So, for example, it is not poor health in itself, which reduces quality of life, but the influence of that poor health upon each informant's ability to, say, be independent, that is important. Amartya Sen's work on functioning and capability is particularly pertinent here. Using this work, it is possible to interpret the five conceptual attributes as a set of functionings-important for older people in the UK in the 21st century-but noting that it is the capacity to achieve these functionings that appears to be of importance. This suggests that further development of this measure should focus on an index of capability rather than preference-based utility.

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Authors: Grewal, I., Lewis, J., Flynn, T., Brown, J., Bond, J., & Coast, J.
Affiliations: University of Bristol (GB)
Eli Lilly (United Kingdom) (GB)
Newcastle University (GB)
Corresponding author: Coast, Joanna
ORCID: Brown, Jackie
Coast, Joanna
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 2006-04
Volume: 62
Issue: 8
Pages: 1891-1901
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/j.socscimed.2005.08.023
OpenAlex: W2010355623
Cited by: 402
References: 55
Citations by year: 2026: 13 · 2025: 18 · 2024: 26 · 2023: 17 · 2022: 29 · 2021: 35 · 2020: 27 · 2019: 25 · 2018: 26 · 2017: 28 · 2016: 30 · 2015: 18 · 2014: 19 · 2013: 17 · 2012: 15
FWCI: 7.60
Type: journal article
Language: en
Open access: green
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
OPUS - Open Publications of UTS Scholars (University of Technology Sydney) (submittedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Explore Bristol Research (submittedVersion)
Newcastle University ePrints (Newcastle Univesity)
Funders: Medical Research Council
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Health Sciences › Health Professions › General Health Professions › Aging, Elder Care, and Social Issues
Keywords: quality of life, older adults, capability approach, functioning, Amartya Sen, health-related quality of life, resource allocation, integrated care, independence
MeSH terms: Activities of Daily Living, Aged, Aged, 80 and over, Choice Behavior, Female, United Kingdom, Humans, Interviews as Topic, Male, Personal Satisfaction, Quality of Life

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Developing attributes for a generic quality of life measure for older people: preferences or capabilities?

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