Department of Gastroenterology, Buddhist Tzu Chi Medical Foundation, Taipei Tzu-Chi Hospital, New Taipei City, Taiwan.
Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
Health Qual Life Outcomes. 2022 Sep 5;20(1):130. doi: 10.1186/s12955-022-02038-1.
Chronic viral hepatitis is a major global public health problem. The guidelines suggest the long-term performance of regular ongoing liver examinations to monitor liver inflammation and screen for hepatocellular carcinoma. However, the effects of regular liver examinations on health-related quality of life (HRQoL) have not been adequately evaluated. Therefore, this study evaluated the effects of regular ongoing examinations on the quality of life of patients with hepatitis.
A cross-sectional study was conducted from October to December 2016 in four hospitals in northern Taiwan. A hepatitis pay-for-performance (P4P) program was launched in 2010 to ensure that hepatitis patients have regular ongoing liver examinations. The study group consisted of patients who joined and stayed in the program for more than one year. The study assessed HRQoL utilizing the five-level version of the EuroQol-5 Dimension (EQ-5D-5L) and the EuroQoL visual analog scale (EQ-VAS). The responses for the EQ-5D-5L in hepatitis patients were transformed into the EQ-5D index according to the Taiwanese population's value set. Sociodemographic and clinical characteristics were collected by questionnaire, and descriptive statistics were presented. A two-part model and generalized linear model with a Poisson distribution and a log link function, respectively, were used to examine the associations of the EQ-5D index and EQ-VAS score with participation in the hepatitis P4P program. We applied propensity score weighting with inverse probability weighting to control for selection bias.
In all, 508 patients (aged 57.6 ± 11.6 years; 60.8% male) were enrolled in this study. The mean (standard deviation, SD) reported EQ-5D index and EQ-VAS scores were 0.93 (0.12) and 75.1 (13.8), and the median (interquartile range, IQR) values were 1 (0.108) and 80 (15), respectively. The study group had a moderately significantly higher EQ-VAS score (mean ratio = 1.029, P < 0.001). However, the differences in the EQ-5D index scores between the study and control groups were not significant.
Patients with hepatitis partially benefited from receiving hepatitis P4P in Taiwan, which featured regular ongoing liver examinations, in that their EQ-VAS scores were enhanced but not their EQ-5D index scores.
慢性病毒性肝炎是一个全球性的重大公共卫生问题。指南建议长期进行定期的肝脏检查，以监测肝脏炎症并筛查肝细胞癌。然而，定期的肝脏检查对健康相关生活质量（HRQoL）的影响尚未得到充分评估。因此，本研究评估了定期进行检查对肝炎患者生活质量的影响。
本研究于 2016 年 10 月至 12 月在台湾北部的四家医院进行了一项横断面研究。2010 年启动了肝炎按绩效付费（P4P）计划，以确保肝炎患者定期进行肝脏检查。研究组包括参加并持续参加该计划一年以上的患者。该研究利用欧洲五维健康量表（EQ-5D-5L）的五级版本和欧洲五维健康量表视觉模拟量表（EQ-VAS）评估 HRQoL。根据台湾人群的价值集，将肝炎患者的 EQ-5D-5L 回答转换为 EQ-5D 指数。通过问卷调查收集社会人口统计学和临床特征，并呈现描述性统计数据。使用两部分模型和广义线性模型，分别采用泊松分布和对数链接函数，检查 EQ-5D 指数和 EQ-VAS 评分与参与肝炎 P4P 计划的关联。我们应用逆概率加权的倾向评分加权来控制选择偏差。
共有 508 名患者（年龄 57.6±11.6 岁；60.8%为男性）参加了这项研究。报告的 EQ-5D 指数和 EQ-VAS 评分的平均值（标准差）分别为 0.93（0.12）和 75.1（13.8），中位数（四分位距，IQR）分别为 1（0.108）和 80（15）。研究组的 EQ-VAS 评分略高（平均比值=1.029，P<0.001）。然而，研究组和对照组的 EQ-5D 指数得分差异无统计学意义。
在台湾，接受包含定期肝脏检查的肝炎 P4P 部分使肝炎患者受益，因为他们的 EQ-VAS 评分提高了，但 EQ-5D 指数评分没有提高。
