Abstract
BackgroundThis study aims to compare the performance of the recently developed Chinese (city) tariff of the EQ-5D-3L against the UK, US, Japanese and Korean tariffs in a general rural population in China.MethodsFrom November 2015 to September 2016, 12,085 permanent residents aged 45–69 from 257 villages randomly selected from Hua County, Henan Province, China, were interviewed using EQ-5D-3L, and a one-on-one questionnaire investigation was used to collect data on factors associated with HRQOL. The health utility scores were calculated using the UK, US, Japanese, Korean and Chinese (city) tariffs. The agreement, known-groups validity and sensitivity of these five tariffs were evaluated. Transition scores for pairs of observed EQ-5D-3L health states were calculated and compared.ResultsThe Korean tariff yielded the highest mean health utility score (0.963), followed by the Chinese (city) (0.948), US (0.943), UK (0.930) and Japanese (0.921) tariffs, but the differences in the scores of any two tariffs did not exceed the MCID. The Chinese (city) tariff showed higher ICC values (ICCs> 0.89, 95% CI:0.755–0.964) and narrower limits of agreement (0.099–0.167) than the Korean tariff [(ICCs> 0.71, 95% CI:0.451–0.955); (0.146–0.253)]. The Chinese (city) tariff had a higher relative efficiency and effect size statistics in 10 out of 11 variables as compared to the UK, US and Japanese tariffs. The Chinese (city) tariff (0.215) was associated with moderate mean absolute transition scores compared with the UK (0.342), US (0.230), Japanese (0.149) and Korean (0.189) tariffs for 1485 observed pairs of the EQ-5D-3L health states.ConclusionsHealth utility scores derived from the five tariffs differed. The Chinese (city) tariff was the most suitable of these tariffs and was without obvious weakness. We recommend adopting the Chinese (city) tariff when applying EQ-5D-3L to assess quality of life among the elderly in China’s agricultural region with socio-economic status similar to Hua County. Results of this study had provided a crucial basis for health surveys, health promotion projects, health intervention trials, and health economic evaluation taking HRQOL as a target in rural areas of China.
Highlights
This study aims to compare the performance of the recently developed Chinese tariff of the EQ5D-3L against the United Kingdom (UK), United States (US), Japanese and Korean tariffs in a general rural population in China
From 2015 to 2016, a total of 12,085 permanent residents from rural Hua County were enrolled in this study
The difference in health utility scores estimated based on the five tariffs was statistically significant (F = 328.61, p < 0.001)
Summary
This study aims to compare the performance of the recently developed Chinese (city) tariff of the EQ5D-3L against the UK, US, Japanese and Korean tariffs in a general rural population in China. Measures of health related quality of life (HRQOL) have become increasingly important in evaluating outcomes of health-care programs [1]. Among generic instruments of HRQOL, the three-level European quality of life fivedimension (EQ-5D-3L) scale is a widely applied preference-based outcome measure worldwide, as it is simple, easy to apply and yields high response rates [2]. Each health state can be converted into health utility scores with tariffs derived primarily from samples of the general public, patients or healthcare providers. Health utility scores represent an individual’s overall health status, and generally range from 0.0 (death) to 1.0 (perfect health). Some very poor health states, such as a persistent vegetative state, may be represented by health utility scores below 0.0 [4]
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