Health, Health-Related Quality of Life, and Quality of Life: What is the Difference?

Abstract

The terms health, health-related quality of life (HRQoL), and quality of life (QoL) are often used interchangeably. Given that these are three key terms in the literature, their appropriate and clear use is important. This paper reviews the history and definitions of the terms and considers how the terms have been used. It is argued that the definitions of HRQoL in the literature are problematic because some definitions fail to distinguish between HRQoL and health or between HRQoL and QoL. Many so-called HRQoL questionnaires actually measure self-perceived health status and the use of the phrase QoL is unjustified. It is concluded that the concept of HRQoL as used now is confusing. A potential solution is to define HRQoL as the way health is empirically estimated to affect QoL or use the term to only signify the utility associated with a health state. Key points for decision makers-The term HRQoL is not well defined and most definitions of HRQoL do not sufficiently differentiate the term from health or QoL -Measures of HRQoL are usually more appropriately named measures of selfperceived health status -A clearer use of HRQoL would be to only use it to signify empirical studies of how health affects QoL or to signify the utility associated with a health state Acknowledgement JB proposed initial ideas and paper structure, MK wrote the first and the revised drafts after discussion with JB. JB made comments and revisions on all drafts. Both JB and MK responded to comments from referees.

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