Fatima Al Sayah1, Nick Bansback2, Stirling Bryan2, Arto Ohinmaa1, Lise Poissant3, Eleanor Pullenayegum4, Feng Xie5,6,7, Jeffrey A Johnson8. 1. 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, AB, T6G 2E1, Canada. 2. Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. 3. School of Rehabilitation, Université de Montréal, Montreal, QC, Canada. 4. Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada. 5. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. 6. Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada. 7. Program for Health Economics and Outcome Measures, Hamilton, ON, Canada. 8. 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, AB, T6G 2E1, Canada. jeff.johnson@ualberta.ca.
Abstract
BACKGROUND: Previous studies suggest that population subgroups have different perceptions of health, as well as different preferences for hypothetical health states. OBJECTIVE: To identify determinants of health states preferences elicited using time trade-off (TTO) for the 5-level EQ-5D questionnaire (EQ-5D-5L) in Canada. METHODS: Data were from the Canadian EQ-5D-5L Valuation Study, which took place in Edmonton, Hamilton, Montreal, and Vancouver. Each respondent valued 10 of 86 hypothetical health states during an in-person interview using a computer-based TTO exercise. The TTO scores were the dependent variable and explanatory variables including age, sex, marital status, education, employment, annual household income, ethnicity, country of birth, dwelling, study site, health literacy, number of chronic conditions, previous experience with illness, and self-rated health. RESULTS: Average [standard deviation (SD)] age of respondents (N = 1209) was 48 (17) years, and 45 % were male. In multivariable linear regression models with random effects, adjusted for severity of health states and inconsistencies in valuations, older age [unstandardized regression coefficient (β) = -0.077], male sex (β = 0.042), being married (β = 0.069), and urban dwelling (β = -0.055) were significantly associated with health states scores. Additionally, participants from Edmonton (β = -0.124) and Vancouver (β = -0.156), but not those from Hamilton, had significantly lower TTO scores than those from Montreal. CONCLUSIONS: Socio-demographic characteristics were the main determinants of preferences for EQ-5D-5L health states in this study. Interestingly, preferences were significantly lower in western Canadian cities compared to eastern ones, bringing into question whether a single preference algorithm is suitable for use in all parts of Canada.
BACKGROUND: Previous studies suggest that population subgroups have different perceptions of health, as well as different preferences for hypothetical health states. OBJECTIVE: To identify determinants of health states preferences elicited using time trade-off (TTO) for the 5-level EQ-5D questionnaire (EQ-5D-5L) in Canada. METHODS: Data were from the Canadian EQ-5D-5L Valuation Study, which took place in Edmonton, Hamilton, Montreal, and Vancouver. Each respondent valued 10 of 86 hypothetical health states during an in-person interview using a computer-based TTO exercise. The TTO scores were the dependent variable and explanatory variables including age, sex, marital status, education, employment, annual household income, ethnicity, country of birth, dwelling, study site, health literacy, number of chronic conditions, previous experience with illness, and self-rated health. RESULTS: Average [standard deviation (SD)] age of respondents (N = 1209) was 48 (17) years, and 45 % were male. In multivariable linear regression models with random effects, adjusted for severity of health states and inconsistencies in valuations, older age [unstandardized regression coefficient (β) = -0.077], male sex (β = 0.042), being married (β = 0.069), and urban dwelling (β = -0.055) were significantly associated with health states scores. Additionally, participants from Edmonton (β = -0.124) and Vancouver (β = -0.156), but not those from Hamilton, had significantly lower TTO scores than those from Montreal. CONCLUSIONS: Socio-demographic characteristics were the main determinants of preferences for EQ-5D-5L health states in this study. Interestingly, preferences were significantly lower in western Canadian cities compared to eastern ones, bringing into question whether a single preference algorithm is suitable for use in all parts of Canada.
Entities:
Keywords:
Canada; EQ-5D; Health preferences; Time trade-off (TTO)
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