Abstract
Little is known about patients reporting extremely poor health-related quality of life (HRQoL). This study targeted population with inferior HRQoL and examined their problems experienced with HRQoL dimensions, and impacts of different morbidities on these problems. Data were obtained from a population-based survey in Korea. HRQoL was measured by EQ-5D questionnaire and low-HRQoL population was defined as individuals whose EQ-5D utility score was among the lowest 5% of total survey population. Logistic regression models were used to evaluate the impact of fifteen morbidities on HRQoL dimensions. Of 2976 low-HRQoL participants, females and low socioeconomic individuals were predominant. They experienced significantly more problems in all dimensions, with pain/discomfort, and mobility as the most frequently reported problems. Problems in HRQoL dimensions diverged according to diseases. Individuals with arthritis experienced more difficulties with mobility (aOR 2.62, 95% CI 1.77–3.87) and pain/discomfort (aOR 2.86, 95% CI 1.78–4.60). Stroke patients experienced more problems in self-care (aOR 2.24, 95% CI 1.59–3.15) and usual activities (aOR 1.87, 95% CI 1.11–3.14). Having two or more diseases was associated with worse outcomes in usual activities and increased risk of depression. Thus, efforts to improve status of low-HRQoL should be customized to fulfil unmet needs corresponding to various diseases, and depression prevention is needed for those with multimorbidity status.
Highlights
Little is known about patients reporting extremely poor health-related quality of life (HRQoL)
In Korea, EQ-5D was measured in an annual nationwide health survey, namely the Korean National Health and Nutrition Examination Survey (KNHANES) since 2 0057
This article contributes to society health literature by exploring the population who experienced extremely low HRQoL and, further, better understanding their problems in disease-comparative settings
Summary
Little is known about patients reporting extremely poor health-related quality of life (HRQoL). Despite the overall economic growth in Korea, a certain population still experienced low or extremely low HRQoL Identifying these particular populations and understanding their sociodemographic characteristics or what health problems are impairing conditions might help improve the overall HRQoL of the community. Many studies on the relationship between morbidities and HRQoL primarily focus on one specific disease or condition, such as arthritis[2], bone mineral density[3], chronic kidney d isease[4], and its negative impact on HRQoL. In Korea, EQ-5D was measured in an annual nationwide health survey, namely the Korean National Health and Nutrition Examination Survey (KNHANES) since 2 0057 Using this population-based survey, we first targeted those who reported having extremely low QoL and aimed to understand their demographic as well as morbidity characteristics. As previous evidence yields gender and socioeconomic inequalities in HRQoL in the Korean population[8,9], we investigated whether inequalities exist among this low-HRQoL population
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