Department of Health Administration and Management, Soonchunhyang University, 22 Soonchunhyang-ro, Shinchang-myeon, Asan, Chungnam, 31538, Republic of Korea.
Department of Sociology, State University of New York, University at Buffalo, Buffalo, NY, USA.
Qual Life Res. 2020 Dec;29(12):3213-3222. doi: 10.1007/s11136-020-02599-y. Epub 2020 Aug 8.
This study compares the self-rated health (SRH) of South Korean and US respondents, using anchoring vignettes to adjust for reporting heterogeneity, i.e., cross-national differences in use of response categories.
Study participants, ages 20 to 59, were recruited from online survey panels retained by Embrain in Korea (N = 1170) and the US (N = 1033). In the analyses, we first examined the two key measurement assumptions of the anchoring vignette method. Response consistency was examined by regressing SRH on vignette ratings and EQ-5D, and was satisfied when the relationship between SRH and vignette ratings was significant and positive. Vignette equivalence was assessed by examining whether respondents correctly rank-ordered vignettes by health status severity. We then compared estimates of the between-country difference in SRH from two models: a standard ordered probit regression, and a hierarchical ordered probit (Hopit) regression, which adjusted for cross-country differences in use of response categories.
The anchoring vignettes satisfied both measurement assumptions. Results from the ordered probit regression indicated that Korean SRH was worse than that in the US. However, results from the Hopit regression revealed that Korean SRH was actually better than that in the US, after adjusting for Korean respondents' significantly higher intercategory thresholds (demarcating between "very bad" and "bad," "bad" and "fair," etc.).
The apparently lower SRH of Korean vis-à-vis US respondents is an artifact of Koreans' higher standards for health-related response categories. After adjusting for these different standards, Korean SRH is revealed to be higher than US SRH.
本研究通过锚定情景来调整报告异质性（即国家间在反应类别使用上的差异），比较韩国和美国受访者的自评健康（SRH）。
研究对象为年龄在 20 至 59 岁之间的在线调查小组的参与者，该小组由韩国的 Embrain（N=1170）和美国的 Embrain（N=1033）保留。在分析中，我们首先检验了锚定情景方法的两个关键测量假设。通过将 SRH 回归到情景评级和 EQ-5D 来检验反应一致性，当 SRH 与情景评级之间的关系显著且为正时，反应一致性得到满足。通过检验受访者是否根据健康状况严重程度正确对情景进行排序，评估情景等效性。然后，我们比较了两种模型（标准有序概率回归和分层有序概率回归（Hopit））中对 SRH 进行跨国差异估计的结果，后者调整了对反应类别的跨国差异使用。
锚定情景满足了这两个测量假设。有序概率回归的结果表明，韩国的 SRH 比美国差。然而，Hopit 回归的结果表明，在调整了韩国受访者的明显更高的类别间阈值（将“非常差”和“差”、“差”和“一般”等分开）后，韩国的 SRH 实际上比美国好。
与美国受访者相比，韩国人自评健康状况明显较差，这是韩国人对健康相关反应类别的标准较高所致。在调整了这些不同的标准后，韩国的 SRH 被揭示为高于美国的 SRH。
