School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, 300072, China.
Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
BMC Public Health. 2023 Jan 24;23(1):167. doi: 10.1186/s12889-023-15075-2.
Quality of life (QoL) is one of the most important indicators for evaluating an individual's overall health status. However, evidence exploring the trend in QoL of the Chinese population is still lacking. This study aimed to investigate the trend in QoL of the Chinese population measured by the EQ-5D from 2008 to 2020, as well as compare the changing trends in QoL categorized by populations with different socio-demographic characteristics.
Data were obtained from the 2008, 2013, and 2020 waves of the Health Services Surveys conducted in Tianjin, China. Respondents completed the EQ-5D (EQ-5D-3L in 2008 and 2013 and EQ-5D-5L in 2020) through face-to-face interviews or self-administration. Responses of the EQ-5D-3L in 2008 and 2013 were mapped onto the EQ-5D-5L responses, and then converted to utility values using the Chinese value set. The trend in QoL was explored by comparing the percentage of any reported problems on each EQ-5D dimension and the corresponding utility values across the three waves. Subgroup analyses were performed to compare trends in utility values stratified by socio-demographic indicators. The effect of the time variable (year) on utility values was assessed by multiple linear regression analyses using the pooled data.
By analyzing and comparing the three waves of the data (N = 25,939 in the 2008 wave, N = 22,138 in 2013, and N = 19,177 in 2020), an upward trend was observed in the percentages of reporting problems on all five dimensions (p < 0.001), resulting in a decreasing trend in utility values (2008: 0.948, 2013: 0.942, 2020: 0.939, p < 0.001). Utility values declined more over time among the female, the elder, the recipients of medical assistance, the widowed, the unemployed, and respondents with primary or lower education. The effect of the year (Coef. for 2013 = - 0.009, p < 0.001; Coef. for 2020 = - 0.010, p < 0.001) confirmed the downward trend in the utility values.
The overall QoL of the Chinese population decreased over the period from 2008 to 2020. The QoL of the disadvantaged or vulnerable populations in terms of socioeconomic characteristics declined more over time.
生活质量（QoL）是评估个体整体健康状况的最重要指标之一。然而，探索中国人群生活质量趋势的证据仍然缺乏。本研究旨在调查 2008 年至 2020 年期间，中国人群生活质量的趋势，并比较不同社会人口特征人群的生活质量变化趋势。
数据来自中国天津市的 2008 年、2013 年和 2020 年三次健康服务调查。受访者通过面对面访谈或自我管理完成 EQ-5D（2008 年和 2013 年为 EQ-5D-3L，2020 年为 EQ-5D-5L）。2008 年和 2013 年的 EQ-5D-3L 回答被映射到 EQ-5D-5L 回答上，然后使用中国价值集将其转换为效用值。通过比较三个波次中每个 EQ-5D 维度的任何报告问题的百分比和相应的效用值，探讨生活质量的趋势。根据社会人口学指标进行亚组分析，比较效用值的趋势。使用汇总数据，通过多元线性回归分析评估时间变量（年份）对效用值的影响。
通过分析和比较三个波次的数据（2008 年波次为 25939 人，2013 年波次为 22138 人，2020 年波次为 19177 人），我们观察到所有五个维度报告问题的百分比呈上升趋势（p<0.001），导致效用值呈下降趋势（2008 年：0.948，2013 年：0.942，2020 年：0.939，p<0.001）。女性、老年人、接受医疗援助的人、丧偶者、失业者和接受小学或以下教育的受访者中，效用值随时间的推移下降得更多。年份的影响（2013 年的系数为-0.009，p<0.001；2020 年的系数为-0.010，p<0.001）证实了效用值的下降趋势。
2008 年至 2020 年期间，中国人口的总体生活质量下降。在社会经济特征方面处于弱势或脆弱地位的人群的生活质量随时间的推移下降得更多。
