PDB69 - Valuing Health-Related Quality of Life for Inpatients with Diabetes-Related Complications In China

Abstract

Disease burden of type 2 diabetes (T2DM) is escalating. Quite a few studies have evaluated the health-related quality of life (HRQOL) of overall T2DM patients, but few focused on that of inpatients with specific diabetes-related complications. Reliable estimates of the impact of complications on HRQOL are important to understand the event burden and serve for economic evaluation. This study aims to estimate the utility-based HRQOL of inpatients with diabetes-related complications in China, and explore the influencing factors. This is a cross-sectional study conducted in a tertiary hospital in Shandong, China. T2DM patients (≥18 years) hospitalized during January, April and May 2017 for their complications, including ischemic heart disease (IHD), myocardial infarction (MI), congestive heart failure (CHF), stroke, impaired vision (IV), end-stage renal disease (ESRD), ulcer or amputation were recruited. The EuroQOL 5-dimensions 3-level(EQ-5D-3L) instrument was administered to these inpatients through face-to-face interviews. Clinical and sociodemographic data were collected from the survey. One-way analysis of variance and multiple linear regression analysis were performed. 802 T2DM inpatients (female 43%) provided data. Mean age was 62.67(SE:0.4) years. The most prevalent problems reported were impairments in Usual Activities. Mean EQ-5D index score of the total sample was 0.562(SE:0.007), with EQ-VAS score of 61.72(SE:0.606). HRQOL varied between complications with significant differences. Mean EQ-5D index scores were: IHD 0.620(0.012), MI 0.434(0.020), CHF 0.471(0.019), stroke 0.472(0.018), IV 0.714(0.012), ESRD 0.693(0.012), ulcer 0.431(0.029), and amputation 0.395(0.027). Mean EQ-VAS scores were: IHD 65.26(1.120), MI 58.84(1.722), CHF 56.70(1.800), stroke 58.59(1.565), IV 66.18(1.418), ESRD 63.57(1.568), ulcer 60.86(2.589), and amputation 55.00(5.426). Complication, exercise, confidence in treatment, worry about the disease were reported to influence the HRQOL. HRQOL of T2DM inpatients was largely impaired. Our estimates demonstrate the magnitude of the impact of eight complications on utility-based measures of HRQOL, which may be used for public health and cost-effectiveness modeling.