Webb Edward J D, Kind Paul, Meads David, Martin Adam
Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Health Econ. 2021 Sep;30(10):2547-2560. doi: 10.1002/hec.4399. Epub 2021 Jul 23.
General population health state values are used in healthcare resource allocation, including health technology assessment. We examine whether UK general population health valuations changed during the COVID-19 pandemic. Ratings of EQ-5D-5L health states 11111 (no problems), 55555 (extreme problems), and dead were collected in a UK general population survey during the pandemic (April-May 2020) using the 0 = worst imaginable health, 100 = best imaginable health visual analog scale (EQ-VAS). Ratings for 55555 were transformed to a full health = 1, dead = 0 scale. Responses were compared to similar data collected pre-pandemic (2018). After propensity score matching to minimize sample differences, EQ-VAS responses were analyzed using Tobit regressions. On the 0-100 scale, 11111 was rated on average 8.67 points lower, 55555 rated 9.56 points higher, and dead rated 7.45 points lower post-pandemic onset compared to pre-pandemic. On the full health = 1, dead = 0 scale, 55555 values were 0.09 higher post-pandemic onset. There was evidence of differential impacts of COVID-19 by gender, age, and ethnicity, although only age impacted values on the 1-0 scale. COVID-19 may have affected how people value health. It is unknown whether the effect is large enough to have policy relevance, but caution should be taken in assuming pre-COVID-19 values are unchanged.
一般人群健康状态值用于医疗资源分配,包括卫生技术评估。我们研究了英国一般人群的健康估值在新冠疫情期间是否发生了变化。在疫情期间(2020年4月至5月),通过英国一般人群调查收集了EQ-5D-5L健康状态11111(无问题)、55555(极端问题)和死亡状态的评分,使用0 = 可想象的最差健康状态,100 = 可想象的最佳健康状态的视觉模拟量表(EQ-VAS)。55555的评分被转换为完全健康 = 1,死亡 = 0的量表。将这些回答与疫情前(2018年)收集的类似数据进行比较。在进行倾向得分匹配以尽量减少样本差异后,使用托比特回归分析EQ-VAS的回答。在0至100的量表上,与疫情前相比,疫情后11111的平均评分低8.67分,55555的评分高9.56分,死亡状态的评分低7.45分。在完全健康 = 1,死亡 = 0的量表上,疫情后55555的值高0.09。有证据表明新冠疫情对不同性别、年龄和种族有不同影响,尽管只有年龄对1至0量表上的值有影响。新冠疫情可能影响了人们对健康的重视程度。目前尚不清楚这种影响是否大到具有政策相关性,但在假设疫情前的值不变时应谨慎。