# Recovery trajectories after a serious injury or illness: a longitudinal evaluation of health-related quality of life in an Australian cohort

## TL;DR

This study tracks how health and quality of life recover over six years after serious injuries or illnesses in an Australian population.

## Contribution

The study quantifies long-term HRQoL recovery and economic costs using a longitudinal Australian cohort with PSM-DiD analysis.

## Key findings

- HRQoL declined by 0.020 QALYs in the year of injury/illness, reaching a trough of 0.032 by year three.
- Mental health losses persisted longer than physical health losses after serious injuries or illnesses.
- Economic costs per person rose from $685 to $1,250 by the third year post-event due to QALY loss.

## Abstract

Serious injuries or illnesses impose a significant burden on the affected individuals. This study examined the long-term recovery of health-related quality of life (HRQoL) after a serious injury or illness and quantified the economic costs attributable to the quality-adjusted life-years (QALYs) lost to serious injury or illness.

Data were sourced from the Household, Income and Labour Dynamics in Australia (HILDA) database. The propensity score matching-difference-in-differences (PSM-DiD) method was used to explore the recovery of HRQoL over a six-year follow-up period. HRQoL was measured by the short-form six-dimension utility index, physical health, and mental health.

We found that those who suffered any serious injuries or illnesses had a decline of 0.020 in QALYs during the year of event, reducing further until a trough of 0.032 by the third year and thereafter began to recover. Further analyses revealed that although serious injuries or illnesses had a significantly greater loss in physical health, the loss in mental health persisted over a longer period. Finally, the economic cost associated with the lost in QALYs due to serious injuries or illnesses was estimated at $685 per person during the year of event and increased to a peak of $1,250 per person by the end of the third-year post-exposure.

Our findings highlight that follow-up care designed to mitigate the impacts of a serious injury or illness on people’s HRQoL should consider cost-effective strategies that are long-lasting and support those affected throughout at least, the first three years of their injuries or illnesses.

The online version contains supplementary material available at 10.1007/s11136-025-03919-w.