Purpose: Whether the expectation of compensation for morbidity costs has an influence on assessments of quality of life (QOL) has not been established. If this expectation affects QOL, then QOL assessments that ignore any expected compensation, when compensation exists, will be biased. Most studies assume that compensation has no influence on assessments of QOL. This analysis provides empirical evidence suggesting that the expectation of compensation for morbidity costs influences assessments of QOL. The results show the importance of linking compensation for morbidity costs to QOL assessments.

Methods: 126 undergraduate students were randomly assigned to one of two groups: (1) participants who were informed they would receive compensation for time lost at work or (2) participants who were not informed they would receive compensation for time lost at work. The participants were further randomly assigned a level of illness severity (mild, moderate, or severe). Participants were asked to read a description of a health state and to assign an assessment of the QOL for that health state using the paper standard gamble. Two-factor analysis of variance was performed on the completed instruments.

Results: The overall mean QOL of those participants who were informed they would receive compensation is significantly higher than those participants who were not informed they would receive compensation (p=0.0005, F=6.37, df = 3, 122).

Conclusion: An individual's assessment of quality of life is influenced by whether compensation for morbidity costs is expected. Therefore, to accurately estimate the quality of life of illnesses or health interventions with linked morbidity costs, expectations of compensation should be addressed.