Health Services Research
HSR 4: National or Novel
Kerra Mercon, MS (she/her/hers)
Research Area Specialist Intermediate
University of Michigan
Washington, District of Columbia, United States
Significant debate prevails on the impacts of COVID-19 illness and necessity for prevention in children, demonstrating a need for cost-effectiveness analyses. Losses in quality-adjusted life years (QALYs) due to varying severities of COVID-19 illness need to be estimated to inform cost-effectiveness analyses of preventive measures, such as vaccination.
To measure how US adults value the effects of COVID-19 illness on quality of life consistent with health economic guidelines to inform cost-effectiveness analyses.
An online stated-preference survey applied the time trade-off (TTO) method to estimate the losses in health-related quality of life due to COVID-19 illness in a nationally representative sample of US adults from the NORC AmeriSpeak panel (Spring 2021, n=1014). The TTO method, commonly used in economic evaluation, asks respondents how much time they would be willing to trade from the end of their life to avoid living in a particular health state. In this study, respondents were asked how much time they would be willing to give up (trade) from the end of their life to prevent COVID-19 illness in their hypothetical child, considering 4 health states of varying severity. Health states included outpatient illness, hospitalization, hospitalization for multisystem inflammatory syndrome in children (MIS-C), or long COVID-19. Demographics and attitudes about COVID-19 vaccination, risk of developing COVID-19, and experience with COVID-19 illness were also collected.
The primary outcome measure was the loss in QALYs calculated from TTO amounts. Descriptive statistics were reported for each health state. Regression and stratified analyses assessed the effects of sociodemographic factors and attitudes about COVID-19 on stated preferences.
Mean QALY losses increased with COVID-19 severity (0.070 QALYs – outpatient, 0.092 QALYs – hospitalized COVID-19, 0.0102 QALYs – MIS-C, 0.110 QALYs – long COVID-19; Table 1). This equates to a range of 26 to 40 mean quality-adjusted life days (QALDs) lost as COVID-19 severity increased from outpatient to long COVID-19. Higher education and higher income were associated with lower QALY losses.
Conclusion(s): This study demonstrates how COVID-19 illness in children leads to decreased health-related quality of life. Specifically, parents are willing to trade off the most time from the end of their life to prevent their child from suffering from long COVID-19, illustrating the importance of incorporating quality of life in cost-effectiveness analyses.