Stewart Susan T, Cutler David M, Rosen Allison B
*National Bureau of Economic Research †Department of Economics, Harvard University ‡Harvard University Interfaculty Program for Health Systems Improvement, Cambridge §Department of Quantitative Health Sciences and Meyer's Primary Care Institute, University of Massachusetts Medical School, Worcester, MA.
Med Care. 2014 Dec;52(12):1010-6. doi: 10.1097/MLR.0000000000000181.
A number of instruments have been developed to measure health-related quality of life (HRQoL), differing in the health domains covered and their scoring. Although few such measures have been consistently included in US national health surveys over time, the surveys have included data on a broad range of symptoms and impairments, which enables the tracking of population health trends.
To compare trends in HRQoL as measured using existing instruments versus using a broader range of symptoms and impairments collected in multiple years of nationally representative data.
Data were from the 2000-2010 Medical Expenditure Panel Survey, which is nationally representative of the noninstitutionalized US population. Level of and trends in HRQoL derived from a broad range of survey symptoms and impairments (SSI) was compared with HRQoL from the SF-6D, the HALex, and, between 2000 and 2003, the EuroQol-5D (EQ-5D) and EQ-5D Visual Analog Scale.
Trends in HRQoL were similar using different measures. The SSI scores correlated 0.66-0.80 with scores from other measures and mean SSI scores were between those of other measures. Scores from all HRQoL measures declined similarly with increasing age and with the presence of comorbid conditions.
Measuring HRQoL using a broader range of symptoms and impairments than those in a single instrument yields population health trends similar to those from other measures while making maximum use of existing data and providing rich detail on the factors underlying change.
已经开发了许多工具来测量与健康相关的生活质量(HRQoL),这些工具在涵盖的健康领域及其评分方面存在差异。尽管随着时间的推移,很少有此类测量方法被一致纳入美国国家健康调查,但这些调查包含了广泛的症状和损伤数据,这使得能够追踪人群健康趋势。
比较使用现有工具测量的HRQoL趋势与使用多年具有全国代表性数据中收集的更广泛症状和损伤所测量的HRQoL趋势。
数据来自2000 - 2010年医疗支出面板调查,该调查对美国非机构化人口具有全国代表性。将从广泛的调查症状和损伤(SSI)得出的HRQoL水平和趋势与SF - 6D、HALex以及2000年至2003年期间的欧洲五维度健康量表(EQ - 5D)和EQ - 5D视觉模拟量表得出的HRQoL进行比较。
使用不同测量方法得出的HRQoL趋势相似。SSI得分与其他测量方法的得分相关性为0.66 - 0.80,且SSI平均得分介于其他测量方法之间。所有HRQoL测量方法的得分随着年龄增长和合并症的存在而类似地下降。
使用比单一工具中包含的更广泛症状和损伤来测量HRQoL,得出的人群健康趋势与其他测量方法相似,同时能最大程度利用现有数据,并提供有关变化背后因素的丰富细节。