A comparison of three health status measures in primary care outpatients

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Abstract
Our objective was to compare a brief, relatively new global health status measure, the Health Utilities Index Mark II (HUI), to two commonly applied health status measures (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] and the Sickness Impact Profile [SIP] in a general medical outpatient population. Using a cross-sectional survey, we surveyed 160 patients in the General Medical Clinic of the Durham Veterans Affairs Medical Center. Each subject answered demographic questions and then completed the three health status measures. The mean time taken to complete the measures was 3, 10, and 20 minutes for the HUI, SF-36, and SIP, respectively (p<.0001). The HUI exhibited a modest “floor” effect; that is, scores were cocnentrated near the sicker of the scale. In contrast, responses to the SIP were heavily concentrated near the healthier end of the scale. Spearman correlation coefficients between the HUI and scales within the other two measures ranged from .54 (SF-36 mental health) to 0.69 (SF-36 physical functioning). Subjects accepted all measures well. These three health service measures varied in their distribution of responses and time required to complete. Users should consider the degree of sickness of the population to be assessed when choosing a measure.