Qiang Yao1,2, Chaojie Liu2, Yaoguang Zhang3, Ling Xu4. 1. School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China. 2. School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia. 3. Centre for Health Statistics Information, National Health Commission, Beijing, China. 4. China Health Human Resources, National Health Commission, Beijing, China.
Abstract
BACKGROUND: EQ-5D-3L is one of the most commonly used instruments for assessing health-related quality of life and cost-utility analyses, but it is not yet available in China. This study aims to develop population norms for the EQ-5D-3L in China in order to encourage appropriate use and interpretation of the EQ-5D-3L instrument. METHODS: Data were extracted from the 2013 National Health Services Survey on a nationally representative sample of 188 720 participants. The utility index based on the 2018 Chinese preference-based value sets were calculated for the participants with different demographic and socio-economic characteristics. Differences in reported problems and visual analogue scale (VAS) and utility index scores were tested using a logistic, linear and tobit regression model, respectively. RESULTS: The Chinese respondents were less likely to report problems on the EQ-5D dimensions compared with most populations in other countries. Pain/discomfort was the most commonly reported problem (12.6%). This resulted in a high ceiling effect (84.19%) on the utility index and high mean scores for the utility index (0.985 ± 0.056) and VAS (80.91 ± 13.74) in the Chinese population. Those who were younger, better educated, employed, married, had no illness condition, lived in a more developed region and had a higher income obtained higher scores in both VAS and utility index. The VAS and utility index scores were also associated with gender, residency and lifestyles, but not always in a consistent way. Male and rural residents had a higher VAS score but not in the utility index compared with their female and urban counterparts. CONCLUSIONS: This study provides national population norms for the EQ-5D-3L based on the 2018 Chinese preference-based value sets. The norms can be used as a reference for health evaluation studies. Cautions need to be taken for presenting and interpreting the utility index results given the high ceiling effect of the EQ-5D-3L instrument.
BACKGROUND: EQ-5D-3L is one of the most commonly used instruments for assessing health-related quality of life and cost-utility analyses, but it is not yet available in China. This study aims to develop population norms for the EQ-5D-3L in China in order to encourage appropriate use and interpretation of the EQ-5D-3L instrument. METHODS: Data were extracted from the 2013 National Health Services Survey on a nationally representative sample of 188 720 participants. The utility index based on the 2018 Chinese preference-based value sets were calculated for the participants with different demographic and socio-economic characteristics. Differences in reported problems and visual analogue scale (VAS) and utility index scores were tested using a logistic, linear and tobit regression model, respectively. RESULTS: The Chinese respondents were less likely to report problems on the EQ-5D dimensions compared with most populations in other countries. Pain/discomfort was the most commonly reported problem (12.6%). This resulted in a high ceiling effect (84.19%) on the utility index and high mean scores for the utility index (0.985 ± 0.056) and VAS (80.91 ± 13.74) in the Chinese population. Those who were younger, better educated, employed, married, had no illness condition, lived in a more developed region and had a higher income obtained higher scores in both VAS and utility index. The VAS and utility index scores were also associated with gender, residency and lifestyles, but not always in a consistent way. Male and rural residents had a higher VAS score but not in the utility index compared with their female and urban counterparts. CONCLUSIONS: This study provides national population norms for the EQ-5D-3L based on the 2018 Chinese preference-based value sets. The norms can be used as a reference for health evaluation studies. Cautions need to be taken for presenting and interpreting the utility index results given the high ceiling effect of the EQ-5D-3L instrument.
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