Liao Meixia, Luo Nan, Rand Kim, Yang Zhihao
Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
Qual Life Res. 2023 Aug;32(8):2329-2339. doi: 10.1007/s11136-023-03394-1. Epub 2023 Mar 22.
This study aimed to compare health preferences for EQ-5D-5L health states between urban and rural populations in China.
This study used pooled secondary data from two EQ-5D-5L valuation studies. Participants were recruited from Guizhou province and Chongqing municipality, China using quota sampling. Each participant was interviewed face-to-face to value a set of 15 or 16 out of 30 EQ-5D-5L health states using time trade-off (TTO) methods including composite TTO and other two variants. Regression analysis was used to compare health state preferences between urban and rural participants.
A total of 597 participants (urban: 55.44%; rural: 44.56%) completed the valuation interviews. Both univariate and multivariable linear regression analyses showed that rural participants tended to value health states lower than urban participants regardless of severity of health states. The unadjusted and adjusted overall mean differences between the two groups were - 0.041 (95% confidence interval [CI] - 0.077, - 0.004, p-value = 0.031) and - 0.040 (95% CI - 0.078, - 0.002, p-value = 0.038), respectively. Predictions for the 3125 health states based on rural participants' health preferences were lower than those based on urban participants' health preferences.
There were small, yet statistically significant, differences in EQ-5D-5L health states preferences between urban and rural populations in China. Future study aiming at establishing a national value set should pay more attention to the sample representativeness.
本研究旨在比较中国城乡居民对EQ-5D-5L健康状态的健康偏好。
本研究使用了来自两项EQ-5D-5L估值研究的汇总二级数据。采用配额抽样方法从中国贵州省和重庆市招募参与者。对每位参与者进行面对面访谈，使用时间权衡（TTO）方法，包括综合TTO和其他两种变体，对30种EQ-5D-5L健康状态中的15种或16种进行估值。采用回归分析比较城乡参与者对健康状态的偏好。
共有597名参与者（城市：55.44%；农村：44.56%）完成了估值访谈。单变量和多变量线性回归分析均显示，无论健康状态的严重程度如何，农村参与者对健康状态的估值往往低于城市参与者。两组之间未调整和调整后的总体平均差异分别为-0.041（95%置信区间[CI]-0.077，-0.004，p值=0.031）和-0.040（95%CI-0.078，-0.002，p值=0.038）。基于农村参与者健康偏好对3125种健康状态的预测低于基于城市参与者健康偏好的预测。
中国城乡居民在EQ-5D-5L健康状态偏好上存在微小但具有统计学意义的差异。未来旨在建立全国价值集的研究应更加关注样本代表性。
