OBJECTIVES: For health economic evaluation using cost-utility analysis, usually quality-adjusted life-years (QALYs) are used to express health benefits. Recently, there has been discussion about expanding outcome measurement in economic evaluation to well-being, aiming to comprehensively evaluate health care interventions. However, it remains uncertain whether appropriate well-being instruments exist for children and adolescents. This study aims to provide an overview of the existing instruments measuring the multidimensional well-being of children and adolescents.

METHODS: This systematic review used the ASReview tool incorporating machine learning in screening. The search strategy, developed by an information specialist, included three groups of terms related to “well-being”, “child or adolescent”, and “instrument”. Four electronic databases (PubMed [Medline], Web of Science, EMBASE, and PsycINFO) were searched. Two reviewers independently used ASReview for screening titles and abstracts and reviewed all relevant full text for eligible studies. Findings were synthesized narratively and through descriptive tables, highlighting consistency, discrepancies, as well as the feasibility for use in economic evaluation.

RESULTS: A total of 23 studies were identified from the 9622 articles found in four databases, primarily conducted between 2010 and 2020. On average the included instruments have five dimensions and 39 question items. None of the well-being instruments found for children and/or adolescents was developed for economic evaluation. Although the rationale behind selecting specific dimensions was often unclear, broader dimensions like physical and psychological well-being were almost always included, and dimensions such as social relationships and environment were also frequently included. Additionally, certain instruments include tailored dimensions such as education, school life and constructive use of time after school.

CONCLUSIONS: Currently there are many well-being instruments for the population of children and adolescents, in line with the many ways of conceptualizing wellbeing. However, at this point there is no instrument exists that is specifically fit for the purpose of economic evaluation.