Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome

Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS).Methods: A sample comprising the general population from Italy, the Netherl...

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Autores principales:	Inge Spronk, Juanita A. Haagsma, Erica I. Lubetkin, Suzanne Polinder, M. F. Janssen, G. J. Bonsel
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	health inequality Europe EQ-5D outcome social determinants Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/780ea9b2c3904432aed2935b5a77e041
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spelling	oai:doaj.org-article:780ea9b2c3904432aed2935b5a77e0412021-11-04T05:12:58ZHealth Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome2296-256510.3389/fpubh.2021.744405https://doaj.org/article/780ea9b2c3904432aed2935b5a77e0412021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpubh.2021.744405/fullhttps://doaj.org/toc/2296-2565Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS).Methods: A sample comprising the general population from Italy, the Netherlands, and United Kingdom (UK) completed the EQ-5D-5L and the EQ VAS. The level of education was selected as a proxy for socio-economic status (SES). EQ-5D-5L level sum scores (LSS) were compared against EQ VAS scores. Stratified and multivariable analyses were used to study the associations between SES and the LSS/EQ VAS relative to the presence of chronic health conditions.Results: A total of 10,172 people participated in this study. In the UK and Netherlands, the LSS was worst for respondents with a low educational level and better for respondents with middle and high educational levels. For Italy, the LSS was best for respondents with a middle educational level compared to respondents with low and high educational levels. The same patterns were observed for the EQ VAS, but differences were slightly smaller. Multivariable analyses showed generally stronger predictive relations in the UK, and with the LSS. The presence of chronic health conditions and being unable to work were independent strong predictors, canceling out the effects of education.Conclusions: In three different European countries, the EQ-5D measures show the presence of education-dependent health inequalities, which are universally explained in regression analysis by independently the presence of chronic health conditions and the inability to work. In stratified analysis, the EQ-5D-5L LSS discriminates slightly better between participants with different levels of SES compared to the EQ VAS.Inge SpronkInge SpronkJuanita A. HaagsmaErica I. LubetkinSuzanne PolinderM. F. JanssenG. J. BonselG. J. BonselFrontiers Media S.A.articlehealth inequalityEuropeEQ-5Doutcomesocial determinantsPublic aspects of medicineRA1-1270ENFrontiers in Public Health, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	health inequality Europe EQ-5D outcome social determinants Public aspects of medicine RA1-1270
spellingShingle	health inequality Europe EQ-5D outcome social determinants Public aspects of medicine RA1-1270 Inge Spronk Inge Spronk Juanita A. Haagsma Erica I. Lubetkin Suzanne Polinder M. F. Janssen G. J. Bonsel G. J. Bonsel Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome
description	Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS).Methods: A sample comprising the general population from Italy, the Netherlands, and United Kingdom (UK) completed the EQ-5D-5L and the EQ VAS. The level of education was selected as a proxy for socio-economic status (SES). EQ-5D-5L level sum scores (LSS) were compared against EQ VAS scores. Stratified and multivariable analyses were used to study the associations between SES and the LSS/EQ VAS relative to the presence of chronic health conditions.Results: A total of 10,172 people participated in this study. In the UK and Netherlands, the LSS was worst for respondents with a low educational level and better for respondents with middle and high educational levels. For Italy, the LSS was best for respondents with a middle educational level compared to respondents with low and high educational levels. The same patterns were observed for the EQ VAS, but differences were slightly smaller. Multivariable analyses showed generally stronger predictive relations in the UK, and with the LSS. The presence of chronic health conditions and being unable to work were independent strong predictors, canceling out the effects of education.Conclusions: In three different European countries, the EQ-5D measures show the presence of education-dependent health inequalities, which are universally explained in regression analysis by independently the presence of chronic health conditions and the inability to work. In stratified analysis, the EQ-5D-5L LSS discriminates slightly better between participants with different levels of SES compared to the EQ VAS.
format	article
author	Inge Spronk Inge Spronk Juanita A. Haagsma Erica I. Lubetkin Suzanne Polinder M. F. Janssen G. J. Bonsel G. J. Bonsel
author_facet	Inge Spronk Inge Spronk Juanita A. Haagsma Erica I. Lubetkin Suzanne Polinder M. F. Janssen G. J. Bonsel G. J. Bonsel
author_sort	Inge Spronk
title	Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome
title_short	Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome
title_full	Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome
title_fullStr	Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome
title_full_unstemmed	Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome
title_sort	health inequality analysis in europe: exploring the potential of the eq-5d as outcome
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/780ea9b2c3904432aed2935b5a77e041
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Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome

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