Meaning

The meaning and usefulness of the QALY is debated.[4][5][6] Perfect health is hard, if not impossible, to define. Some argue that there are health states worse than death, and that therefore there should be negative values possible on the health spectrum (indeed, some health economists have incorporated negative values into calculations). Determining the level of health depends on measures that some argue place disproportionate importance on physical pain or disability over mental health.[citation needed] The effects of a patient's health on the quality of life of others (e.g. caregivers or family) do not figure into these calculations.