预测慢性脊髓损伤患者的健康偏好。
Predicting health preference in chronic spinal cord injury.
作者信息
Mittmann Nicole, Hitzig Sander L, Catharine Craven B
出版信息
J Spinal Cord Med. 2014 Sep;37(5):548-55. doi: 10.1179/2045772314Y.0000000249. Epub 2014 Jul 24.
CONTEXT/OBJECTIVE: Health preference values relate to a person's state of well-being, and is a single metric anchored at 0 (death) and 1 (perfect health). Health preference plays a key role in health economics and health policy, particularly in interpreting the results of cost-effectiveness studies, and supports the allocation of healthcare resources. The current study used elements of the International Classification of Functioning, Disability and Health (ICF) framework to predict health preference in persons with spinal cord injury (SCI).
METHODS
Data were collected by telephone survey on (1) demographics, (2) impairment (etiology, neurological level of injury, and ASIA impairment scale), (3) secondary health conditions (SHCs) using the SCI-Secondary Conditions Scale-Modified, (4) functional abilities using the Spinal Cord Independence Measure (SCIM), and (5) health preference using the Health Utilities Index-Mark III (HUI-Mark III) among adults with chronic SCI. Variables were categorized according to ICF headings and hierarchical regression analyses were used to predict HUI-Mark III scores.
RESULTS
Adults with chronic traumatic or non-traumatic SCI (N = 357) reported a mean health preference score of 0.27 (±0.27). In predicting health preference, our model accounted for 55.1% of the variance with "body functions and structure", and "activity and participation", significantly contributing to the model (P < 0.0001). In particular, older age, being employed, and having higher SCIM scores were positively associated with health preference. Conversely, a higher SHC impact score was associated with poorer health preference.
CONCLUSIONS
Variables representative of "activity and participation" largely influence health preference among persons with chronic SCI, which may be amenable to intervention. These findings could be applied to advocate for health promotion and employment support programs to maximize well-being in persons aging with chronic SCI in the community.
背景/目的：健康偏好值与一个人的幸福状态相关，是一个以0（死亡）和1（完美健康）为锚定的单一指标。健康偏好在健康经济学和健康政策中起着关键作用，特别是在解释成本效益研究的结果时，并支持医疗资源的分配。本研究使用国际功能、残疾和健康分类（ICF）框架的要素来预测脊髓损伤（SCI）患者的健康偏好。
方法
通过电话调查收集数据，内容包括：（1）人口统计学信息；（2）损伤情况（病因、神经损伤水平和美国脊髓损伤协会损伤量表）；（3）使用脊髓损伤继发疾病量表修订版评估的继发健康状况（SHCs）；（4）使用脊髓独立性测量（SCIM）评估的功能能力；（5）慢性SCI成人患者使用健康效用指数-第三版（HUI-第三版）评估的健康偏好。根据ICF标题对变量进行分类，并使用层次回归分析来预测HUI-第三版得分。
结果
慢性创伤性或非创伤性SCI成人患者（N = 357）报告的平均健康偏好得分为0.27（±0.27）。在预测健康偏好时，我们的模型解释了55.1%的方差，“身体功能和结构”以及“活动和参与”对模型有显著贡献（P < 0.0001）。特别是，年龄较大、就业以及较高的SCIM得分与健康偏好呈正相关。相反，较高的SHC影响得分与较差的健康偏好相关。
结论
代表“活动和参与”的变量在很大程度上影响慢性SCI患者的健康偏好，这可能适合进行干预。这些发现可用于倡导健康促进和就业支持计划，以最大限度地提高社区中患有慢性SCI的老年人的幸福感。
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