Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs)

Mackillop, Eleanor ORCID: 0000-0003-3345-7499 and Sheard, SB ORCID: 0000-0001-8116-9120 (2018) Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs). Social Science and Medicine, 211. pp. 359-366.

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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.

Item Type:	Article
Uncontrolled Keywords:	QALY, United Kingdon, History, Health Policy, Health Economics, Multiple Streams Analysis
Depositing User:	Symplectic Admin
Date Deposited:	23 Jul 2018 06:46
Last Modified:	19 Jan 2023 01:30
DOI:	10.1016/j.socscimed.2018.07.004
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3023992