Research On Health Utility Measurement Of Rural Population In Anhui Province Based On Time Trade-off Method

Objective The EQ-5D-5L was used to investigate the quality of life of rural residents in Anhui Province,to explore the utility value model of the EQ-5D-5L of thel population,to analyze the related factors affecting the health related quality of rural residents,and to provide scientific basis and relevant suggestions for improving the health of rural residents in the future.Mothds From July to August 2016,4 rural villages and towns were selected as the research site in Anhui Province by simple random sampling,and the household survey was carried out for 1070 rural residents aged over 16 years.The survey included respondents’basic information,EQ-5D-5L and Time trade-off scale.The time trade-off method was used to evaluate the 86 health states in the EQ-5D-5L,for the health utility value U=T/10,which was better than death,and to the health state utility value U=-T/(10-T),which was less than the death.,by monotonically transforming U’=U/(1-U)and linear transformation U’=U/Min(U)to get the health status utility value that is worse than death.All data was analyzed with SPSS17.0 and STATA11.0.Counting data were expressed by composition ratio or rate.The measurement data are expressed by mean mean standard deviation.The parameter of the rural residents’health utility model is estimated by using the ordinary least square method in multiple linear regression.It is screened most excellent model by the size of R~2 and MAE.The single factor analysis of the quality of life was analyzed by variance analysis and nonparametric test,and the Tobit regression model was used to analyze the related risk factors of the quality of life of rural residents.Results(1)A total of 1070 rural residents were surveyed,of which 25 were excluded from the questionnaire and 1045 were finally included in the analysis of quality of life on the EQ-5D-5L scale.Time trade-off data included 935 data for model building after being logically tested.The average age of the respondents was 46.78±15.54years,and the prevalence rate of chronic diseases was 28.7%.(2)The subjects had EQ-VAS score of 83.82±15.36 and the health utility value of0.895±0.138.Of which,49.8%had no problems in all five dimensions and the samples with the most pain/discomfort dimensions accounted for 42.0%,followed by anxiety/depression dimensions problems accounted for 21.1%;there were less problems in the three dimensions of daily activities,actions and self-care,accounted for 13.0%,12.4%and 5.1%,respectively.(3)86 health states obtained from the EQ-5D-5L scale were measured by the time trade-off method.935 TTO evaluation utility values were obtained by logical test and data screening.After the data were treated by two ways of monotonous conversion and linear conversion,the most important data of the evaluation were worse than those of the dead.The parameter of the small second multiplication model was estimated by the model.The R~2 value of the 5D+C4 model after the linear transformation was 0.907,and the minimum of MAE was 0.033.Therefore,the 5D+C4 model of linear conversion data was the best.The predictive value of 27 states in the 86 health states was higher than the measured values,and the predicted values in the remaining 59 states are lower than the measured values.The prediction error of the state of 89.5%(77/86)was lower than 0.05,and the prediction error of only 9states was higher than 0.05.In addition,the prediction results show that the highest utility value of 11121 health status in 86 health states was 0.874,and the health utility of the 55555 worst health state was-0.015.(4)EQ-VAS scores and five dimensional quality of life analysis showed that there were significant differences in age,marital status,educational level,employment status,physical activity,and chronic patient groups(P<0.05).The results showed that the five dimensions of age,divorced or widowed,primary school,agriculture,and chronic disease were stored.The ratio of anxiety to depression in women were higher than that in other groups.(5)There were statistically significant differences in the five dimensions of action,self care,daily activity,pain/discomfort,anxiety/depression of the residents with chronic diseases,such as marital status,educational level,occupation,physical activity,and chronic diseases(P<0.05);five dimensions of divorced or widowed,primary,agricultural,and chronic diseases were dissimilar or widowed.The proportion of degree of existence were higher than that of other groups.The evaluation of anxiety and depression of women were worse than that of men.(6)Non-parametric test and Tobit regression analysis showed that the difference between health utility values in age,employment,physical activity,drinking and chronic disease was statistically significant(P<0.05),and there was no significant difference in gender and smoking(P>0.05).The results showed that the smaller the age,the higher education level,the healthier utility value of the patients without chronic diseases,the better the quality of life.Conclusions(1)The proportion of the five dimensions being healthy in the sample population is 49.8%and their overall quality of life is high.However,the main health problems in the population are pain or discomfort,especially in the female and the elderly.(2)EQ-VAS,the five dimensional level distribution and health utility can reflect the quality of life of rural residents,including two aspects of the subjective and objective of the crowd.The comprehensive analysis showed that the factors affecting the quality of life of the rural population include age,sex,employment,physical activity,drinking and chronic disease.Combined with multivariate analysis,we can see that the quality of life of elderly patients,unemployed people,low education level,lack of physical activity and chronic group are lower.(3)Based on the survey data of quality of life of rural residents in Anhui Province,based on the Time trade-off measure of health utility value and the final utility value model,the successful construction of the utility value integral system of EQ-5D-5L scale has some shortcomings In the future will be further improved.