Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs)
Eleanor MacKillop and
Sally Sheard
Social Science & Medicine, 2018, vol. 211, issue C, 359-366
Abstract:
Quality-Adjusted Life-Years (QALYs) are central to healthcare decision-making in Britain and abroad, yet their history is poorly understood. In this paper, we argue that a more in-depth and political history of the QALY is needed to allow a critical evaluation of its current dominance. Exploiting rich data from archives and 44 semi-structured interviews conducted between 2015 and 2018, we employ Multiple Streams Analysis to construct a complex and dynamic picture of how the idea of QALYs emerged and was adopted within UK health policy. Through its historical and political approach, the paper illuminates the relative roles in the policy-making process of experts (especially economists) and politicians as ‘entrepreneurs’ in the development of new ideas; how these were influenced by negotiation within established and emerging institutional structures; and the role of serendipity and crisis.
Keywords: United Kingdom; QALY; History; Health policy; Health economics; Multiple-streams analysis (search for similar items in EconPapers)
Date: 2018
References: Add references at CitEc
Citations: View citations in EconPapers (4)
Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0277953618303605
Full text for ScienceDirect subscribers only
Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
HTML/Text
Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:211:y:2018:i:c:p:359-366
Ordering information: This journal article can be ordered from
http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
http://www.elsevier. ... _01_ooc_1&version=01
DOI: 10.1016/j.socscimed.2018.07.004
Access Statistics for this article
Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian
More articles in Social Science & Medicine from Elsevier
Bibliographic data for series maintained by Catherine Liu (repec@elsevier.com).