QualityMetric, Inc,, part of OptumInsight, 24 Albion Road, Building 400, Lincoln, RI 02865, USA.
Health Qual Life Outcomes. 2012 Dec 19;10:154. doi: 10.1186/1477-7525-10-154.
In the US, approximately 53% of adults have at least one chronic condition. Comorbid physical and mental health conditions often have an incremental negative impact on health-related quality of life (HRQL). Primary study objectives were to quantify the impact on HRQL of a) ≥ 1 physical condition , b) ≥ 1 comorbid mental health conditions added to a physical one, c) ≥ 1 mental health condition, and d) ≥ 1 comorbid physical conditions added to at least one related to mental health. Decrements were based on a "Healthy" reference group reporting no chronic conditions.
Participants were sampled (n = 3877) from the US adult population as part of a 2009 normative survey. Demographics, number/ type of chronic conditions, and HRQL data were self-reported. HRQL was defined through SF-36v2® Physical Component Summary (PCS) scores and Mental Component Summary (MCS) scores. Participant "morbidity" groupings included Healthy; Physical Health Condition only, Mental Health Condition only, and Physical and Mental Health (Comorbid). PCS and MCS scores were also analyzed by physical disease clusters (e.g., cardiovascular, gastrointestinal). Multivariate regression models were used for all analyses.
81% of participants were Caucasian; 9% African American. Males and females were about equally represented; 63% were ≥ 45 years old. The average number of reported chronic conditions was 2.4 (SD = 2.4). Relative to the Healthy group, the Physical Condition group scored 6.4 (males) and 7.5 (females) points lower on PCS. The addition of a comorbid mental health condition resulted in a total reduction of 11 points in PCS and 15 points in MCS. Compared to the Healthy group, ≥ 1 mental health conditions was associated with MCS decrements of 11-12 points. A physical comorbidity led to additional decrements of 3-4 points for MCS, with a total of 15 points. Incremental HRQL burden defined by both MCS and PCS scores was relatively similar across the 5 defined physical disease clusters.
Results provide quantitative information for US adults on specific PCS and MCS score decrements associated with a comorbid condition related to mental health, as well as a comorbid condition related to physical health.
在美国，约有 53%的成年人患有至少一种慢性疾病。同时患有身体和精神健康状况的人往往对健康相关生活质量（HRQL）产生累加负面影响。主要研究目标是量化以下情况对 HRQL 的影响：a）≥1 种身体状况，b）在 1 种身体状况的基础上增加≥1 种精神健康合并症，c）≥1 种精神健康状况，以及 d）≥1 种与精神健康相关的身体合并症。基于无慢性疾病的“健康”参考组报告，衰退情况得以确定。
参与者作为 2009 年规范调查的一部分，从美国成年人群中抽取样本（n=3877）。他们的人口统计学特征、慢性疾病的数量/类型以及 HRQL 数据均由其本人报告。HRQL 通过 SF-36v2®身体成分综合评分（PCS）和心理成分综合评分（MCS）来定义。参与者的“发病”分组包括健康、仅身体健康状况、仅心理健康状况以及身体和心理健康（合并症）。还按身体疾病簇（例如心血管、胃肠道）分析 PCS 和 MCS 评分。所有分析均使用多元回归模型。
81%的参与者为白种人；9%为非裔美国人。男性和女性的比例大致相当；63%的参与者年龄在 45 岁以上。报告的慢性疾病平均数量为 2.4（SD=2.4）。与健康组相比，身体状况组的 PCS 评分低 6.4（男性）和 7.5（女性）分。合并一种精神健康合并症会导致 PCS 总评分降低 11 分，MCS 总评分降低 15 分。与健康组相比，≥1 种心理健康状况会导致 MCS 评分降低 11-12 分。身体合并症会导致 MCS 评分进一步降低 3-4 分，总分为 15 分。通过 MCS 和 PCS 评分定义的增量 HRQL 负担在 5 个定义的身体疾病簇中相对相似。
研究结果为美国成年人提供了与心理健康相关的合并症以及与身体健康相关的合并症相关的特定 PCS 和 MCS 评分降低的定量信息。
