丹麦 199 种慢性疾病和健康风险的 EQ-5D-3L 健康相关生活质量评分目录。

IF 1.9 Q3 HEALTH CARE SCIENCES & SERVICES MDM Policy and Practice Pub Date : 2023-04-09 eCollection Date: 2023-01-01 DOI:10.1177/23814683231159023
Michael Falk Hvidberg, Karin Dam Petersen, Michael Davidsen, Flemming Witt Udsen, Anne Frølich, Lars Ehlers, Mónica Hernández Alava
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引用次数: 0

摘要

背景。健康相关生活质量(HRQoL)评估对于估算质量调整生命年至关重要。收集主要的 HRQoL 数据有时并不可行,因此需要可靠的二手数据来源。目前 "现成的 "HRQoL 目录基于较早的诊断分类,包含的疾病数量有限。本文旨在提供:1)基于丹麦 EQ-5D-3L 的 HRQoL 目录,该目录以 199 种具有全国代表性的慢性疾病的 ICD-10 编码为基础;2)基于模型的补充目录,该目录对年龄、性别、合并症、生活方式和健康风险进行了控制。设计。将来自 3 个国家健康调查样本的 55,616 名受访者与 7 个国家登记册(包含患者层面的诊断、医疗保健活动和社会人口统计信息)进行汇总。使用丹麦 EQ-5D-3L 值集将 EQ-5D-3L 数据转换为效用分数,以估算每个慢性病人群的平均效用。对调整后的有限因变量混合模型进行估算,并用于提供基于回归的效用/效用目录。结果丹麦人群中 EQ-5D 平均得分最低的疾病是系统性硬化症(M34;得分 = 0.432)、纤维肌痛(M797;得分 = 0.490)、风湿病(M790;得分 = 0.515)、痴呆症(F00、G30;得分 = 0.546)、创伤后应激综合征(F431;得分 = 0.557)和系统性萎缩症(G10-G14;得分 = 0.583)。根据估计模型,最大的估计损失是囊性纤维化、大脑性麻痹、抑郁症、背痛、硬化症和纤维肌痛。生活方式因素,包括感知到的压力、孤独感和体重指数,也与低 HRQoL 显著相关。结论本研究为丹麦提供了一份全面的具有全国代表性的基于 EQ-5D-3L 的 HRQoL 评分目录和基于模型的目录,可用于描述疾病负担的各个方面和分配医疗资源。此外,还提供了其他 Stata 程序,以方便对其他人群进行预测:本文介绍了丹麦具有全国代表性的 199 种慢性疾病的健康相关生活质量评分目录,该目录提供了慢性疾病亚组的人口估计值,可用于健康经济评估。本文估算了带有不同控制变量集的 EQ-5D-3L 实用性评分的两个独立回归模型,使研究人员能够根据亚组构成的差异进行调整,并提供了一个可用于其他环境的工具。结果表明,不同疾病组的健康相关生活质量各不相同,但肾脏疾病、精神和行为障碍、良性肿瘤以及血液、消化系统和神经系统疾病的健康相关生活质量最低。健康风险和生活方式因素(如感知到的压力、孤独感和体重指数过大)与健康相关生活质量高度相关,在许多情况下,相关性高于与单个疾病的相关性。
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Catalog of EQ-5D-3L Health-Related Quality-of-Life Scores for 199 Chronic Conditions and Health Risks in Denmark.

Background. Assessments of health-related quality of life (HRQoL) are essential in estimating quality-adjusted life-years. It is sometimes not feasible to collect primary HRQoL data, and reliable secondary sources are necessary. Current "off-the-shelf" HRQoL catalogs are based on older diagnosis classifications and include a limited number of diseases. This article aims to provide 1) a Danish EQ-5D-3L-based HRQoL catalog for 199 nationally representative chronic conditions based on ICD-10 codes and 2) a complementary model-based catalog controlling for age, sex, comorbidities, lifestyle, and health risks. Design. A total of 55,616 respondents from 3 national health survey samples were pooled and combined with 7 national registers containing patient-level information on diagnoses, health care activity, and sociodemographics. EQ-5D-3L data were converted to utility scores using the Danish EQ-5D-3L value set to estimate the mean utility for each chronic disease population. Adjusted limited dependent variable mixture models were estimated and used to provide a regression-based catalog of utilities/disutilities. Results. Diseases with the lowest mean EQ-5D score in the Danish population were systemic sclerosis (M34; score = 0.432), fibromyalgia (M797; score = 0.490), rheumatism (M790; score = 0.515), dementia (F00, G30; score = 0.546), posttraumatic stress syndrome (F431; score = 0.557), and systemic atrophies (G10-G14; score = 0.583. Based on the estimated models, the largest estimated disutilities were cystic fibrosis, cerebral palsy, depression, dorsalgia, sclerosis, and fibromyalgia. Lifestyle factors, including perceived stress, loneliness, and body mass index, were also significantly associated with low HRQoL. Conclusions. This study provides a comprehensive nationally representative catalog and a model-based catalog of EQ-5D-3L-based HRQoL scores for Denmark that can be used to describe aspects of disease burden and allocate resources within health care. Additional Stata programs are also provided to facilitate predictions in other populations.

Highlights: A Danish national representative catalog of health-related quality-of-life scores for 199 chronic conditions is presented, which provides population estimates for chronic conditions subgroups that can be used for health economic evaluation.Two separate regression models of EQ-5D-3L utility scores with different sets of control variables are estimated to allow researchers to adjust for differences in the composition of the subgroups and provide a tool that can be used in other settings.Results indicate that health-related quality of life varies across disease groups but is lowest for renal disease, mental and behavioral disorders, benign neoplasms and diseases of the blood, digestive systems, and nervous systems.Health risks and lifestyle factors such as perceived stress, loneliness, and a large body mass index are highly correlated with health-related quality of life, and, in many cases, the correlation is higher than with individual diseases.

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来源期刊
MDM Policy and Practice
MDM Policy and Practice Medicine-Health Policy
CiteScore
2.50
自引率
0.00%
发文量
28
审稿时长
15 weeks
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