Martín-Fernández Jesús, Ariza-Cardiel Gloria, Polentinos-Castro Elena, Sanz-Cuesta Teresa, Sarria-Santamera Antonio, Del Cura-González Isabel
Consultorio de Villamanta (C.S. Navalcarnero), Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Navalcarnero, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain; Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Spain; UDM Atención Familiar y Comunitaria Oeste, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain.
Gac Sanit. 2018 Sep-Oct;32(5):447-453. doi: 10.1016/j.gaceta.2017.05.016. Epub 2017 Sep 27.
To assess the burden of several determinants on health-related quality of life (HRQOL) and to study its heterogeneity among the different Spanish regions.
Cross-sectional study. Data were obtained from the Spanish National Health Survey (2012), and HRQOL was measured using the EQ-5D-5L questionnaire (utility and visual analogue scale -VAS- scores). Demographic variables, physical health condition, social variables, mental health status, and lifestyle were also analysed. Tobit regression models were employed to study the relationships between expressed HRQOL and personal characteristics.
A total of 20,979 surveys were obtained. Of them, 62.4% expressed a utility score of 1, corresponding to perfect health (95%CI: 61.8%-63.2%), and 54.2% showed VAS scores ≥80 (95%CI: 53.5%-54.9%). HRQOL was mainly described as a function of age, chronic limitation in daily activities, and mental health status. Belonging to a higher-class strata and physical activity were related to better self-perceived HRQOL. Ageing worsened perceived HRQOL, but did not influence its determinants, and differences in HRQOL by regions were also not significant after model adjustment.
HRQOL perception in the Spanish population varied slightly depending on the measure used (utilities index or VAS). Age, chronic limitations in daily life, and mental health status best explained the variability in perception, and no meaningful differences in HRQOL perception among regions were found after adjustment.
评估多种决定因素对健康相关生活质量（HRQOL）的影响，并研究其在西班牙不同地区之间的异质性。
横断面研究。数据来源于西班牙国家健康调查（2012年），使用EQ-5D-5L问卷（效用和视觉模拟量表-VAS-得分）测量HRQOL。还分析了人口统计学变量、身体健康状况、社会变量、心理健康状况和生活方式。采用 Tobit 回归模型研究所表达的 HRQOL 与个人特征之间的关系。
共获得20979份调查问卷。其中，62.4%的人效用得分表示为1，对应于完美健康（95%置信区间：61.8%-63.2%），54.2%的人VAS得分≥80（95%置信区间：53.5%-54.9%）。HRQOL主要被描述为年龄、日常活动中的慢性限制和心理健康状况的函数。属于较高社会阶层和进行体育活动与更好的自我感知HRQOL相关。衰老会使感知到的HRQOL恶化，但不影响其决定因素，并且在模型调整后，各地区HRQOL的差异也不显著。
西班牙人群对HRQOL的感知根据所使用的测量方法（效用指数或VAS）略有不同。年龄、日常生活中的慢性限制和心理健康状况最能解释感知的变异性，调整后未发现各地区在HRQOL感知上有有意义的差异。
