Corso Phaedra S, Edwards Valerie J, Fang Xiangming, Mercy James A
Department of Health Policy and Management, College of Public Health, University of Georgia, N125 Paul Coverdell Center, Athens, GA 30602-7397, USA.
Am J Public Health. 2008 Jun;98(6):1094-100. doi: 10.2105/AJPH.2007.119826. Epub 2008 Apr 29.
We sought to assess the difference in a preference-based measure of health among adults reporting maltreatment as a child versus those reporting no maltreatment.
Using data from a study of adults who reported adverse childhood experiences and current health status, we matched adults who reported childhood maltreatment (n = 2812) to those who reported no childhood maltreatment (n = 3356). Propensity score methods were used to compare the 2 groups. Health-related quality-of-life data (or "utilities") were imputed from the Medical Outcomes Study 36-Item Short Form Health Survey using the Short Form-6D preference-based scoring algorithm.
The combined strata-level effects of maltreatment on Short Form-6D utility was a reduction of 0.028 per year (95% confidence interval=0.022, 0.034; P<.001). All utility losses for the childhood-maltreatment versus no-childhood-maltreatment groups by age group were significantly different: 18-39 years, 0.042; 40-49 years, 0.038; 50-59 years, 0.023; 60-69 years, 0.016; 70 or more years, 0.025.
Persons who experienced childhood maltreatment had significant and sustained losses in health-related quality of life in adulthood relative to persons who did not experience maltreatment. These data are useful for assessing the cost-effectiveness of interventions designed to prevent child maltreatment in terms of cost per quality-adjusted life years saved.
我们试图评估报告童年期受虐待的成年人与报告未受虐待的成年人在基于偏好的健康指标上的差异。
利用一项关于报告童年不良经历和当前健康状况的成年人研究的数据,我们将报告童年期受虐待的成年人(n = 2812)与报告未受童年期虐待的成年人(n = 3356)进行匹配。使用倾向得分方法比较两组。使用基于偏好的简式6D评分算法,从医学结局研究36项简短健康调查中推算出与健康相关的生活质量数据(或“效用值”)。
虐待对简式6D效用值的综合分层效应为每年降低0.028(95%置信区间 = 0.022, 0.034;P <.001)。按年龄组划分,童年期受虐待组与未受童年期虐待组的所有效用值损失均有显著差异:18 - 39岁,0.042;40 - 49岁,0.038;50 - 59岁,0.023;60 - 69岁,0.016;70岁及以上,0.025。
与未经历虐待的人相比,经历童年期虐待的人在成年期与健康相关的生活质量有显著且持续的损失。这些数据对于评估旨在预防儿童虐待的干预措施在每质量调整生命年节省成本方面的成本效益很有用。