Abstract
PurposeHealth-related quality of life outcomes are increasingly used to monitor population health and health inequalities and to assess the (cost-) effectiveness of health interventions. The EQ-5D-5L has been included in the Belgian Health Interview Survey, providing a new source of population-based self-perceived health status information. This study aims to estimate Belgian population norms for the EQ-5D-5L by sex, age, and region and to analyze its association with educational attainment.MethodsThe BHIS 2018 provided EQ-5D-5L data for a nationally representative sample of the Belgian population. The dimension scores and index values were analyzed using logistic and linear regressions, respectively, accounting for the survey design.ResultsMore than half of respondents reported problems of pain/discomfort, while over a quarter reported problems of anxiety/depression. The average index value was 0.84. Women reported more problems on all dimensions, but particularly on anxiety/depression and pain/discomfort, resulting in significantly lower index values. Problems with mobility, self-care, and usual activities showed a sharp increase after the age of 80 years. Consequently, index values decreased significantly by age. Lower education was associated with a higher prevalence of problems for all dimensions except anxiety/depression and with a significantly lower index value.ConclusionThis paper presents the first nationally representative Belgian population norms using the EQ-5D-5L. Inclusion of the EQ-5D in future surveys will allow monitoring over time of self-reported health, disease burden, and health inequalities.
Highlights
Health-related quality of life (HRQoL) refers to a person’s self-reported physical, mental, and social functioning and is an important outcome measure to support health care decisions [1]
We aim to present Belgian population norms for the EQ-5D-5L by age, sex, and region, and analyze its association with educational attainment using the most recent data from BHIS 2018, and compare changes in population norms between 2013 and 2018
The BHIS is a cross-sectional household survey, in which participants were selected from the national register through a multistage stratified sample of all persons officially residing in Belgium, without any restrictions on nationality
Summary
Health-related quality of life (HRQoL) refers to a person’s self-reported physical, mental, and social functioning and is an important outcome measure to support health care decisions [1]. The original EQ-5D descriptive system, the EQ-5D-3L, defined three severity levels (no problems, some or moderate problems, extreme problems/unable to) per EQ-5D dimension. In 2009, the more sensitive EQ-5D-5L was launched, with five severity levels (no problems, slight problems, moderate problems, severe problems, extreme problems/unable to) per EQ-5D dimension [2]. Translating the EQ-5D dimension scores into a single index value, or utility, requires an algorithm that can attach values to all possible EQ-5D health states. A utility ranges between 0 (death) and 1 (perfect health), but it can include negative values for health states perceived worse than death [3]. The Belgian value set for the EQ-5D-5L has been developed based on health states preferences from the general population of Belgium [4]
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