Open Access Research

A validation of the ICECAP-O in a population of post-hospitalized older people in the Netherlands

Peter Makai1*, Marc A Koopmanschap2, Werner BF Brouwer2 and Anna AP Nieboer2

Author Affiliations

1 Department of Geriatrics, Radboud University Nijmegen Medical Centre Nijmegen, Renier Postlaan 4, Nijmegen 6525GC, The Netherlands

2 Institute of Health Policy and Management, Erasmus University Rotterdam Burgemeester, Oudlaan 50, Rotterdam 3062, PA, The Netherlands

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Health and Quality of Life Outcomes 2013, 11:57  doi:10.1186/1477-7525-11-57

Published: 8 April 2013



Various healthcare and social services may impact not only health, but wellbeing as well. Such effects may be more fully captured by capability-wellbeing instruments than with Health-related Quality of Life (HrQol) instruments. The aim of this study is to validate the ICEpop (Investigating Choice Experiments for the Preferences of Older People) CAPability measure for Older people (ICECAP-O) capability wellbeing instrument in a population of post-hospitalized older people admitted to a hospital 3 months earlier.


296 post-hospitalized older people in the Netherlands were interviewed 3 months after admission between September 2010 and January 2011. We investigated the convergent validity of the ICECAP-O and overall wellbeing measures (Cantril’s ladder and Social Production Function: Instrument for Level of Well-being (SPF-IL)), as well as with various health measures (EQ5D, Katz-15 Instrumental Activities of Daily Living (IADL) scale, Geriatric Depression Scale (GDS) and the Medical Outcomes Study Short form (SF-20) social functioning dimension). Additionally, we assessed discriminant validity by comparing several relevant subgroups in our sample (based on age, depression, IADL dependency, living situation, etc.). We also investigated the relationship between overall wellbeing and the ICECAP-O, controlling for HrQol and background characteristics.


This study suggests that the ICECAP-O has good convergent validity with wellbeing measures as well as health measures and discriminates between various groups of post-hospitalized older people. Wellbeing measured by both Cantril’s ladder and SPF-IL is associated with the ICECAP-O in a multivariate analysis controlling for HRQoL as well.


The ICECAP-O seems to be a valid instrument of capability-wellbeing in older, post-hospitalized people, showing good convergent validity with health and wellbeing instruments, and is able to discriminate between elderly with various health profiles. The ICECAP-O measure seems to capture both health and wellbeing. Therefore it is a promising instrument for assessing the outcomes of health and social services aimed at older people.

Capability wellbeing; Health-related quality of life; ICECAP-O; Post-hospitalized elderly