Determinants of the acceptability of health problems in different ages: exploring a new application of the EQ VAS

We aimed to determine the acceptability of non-perfect health states with age using the EQ VAS and analyse the influencing factors.

We conducted a cross-sectional survey on a convenience sample from the general population (N = 200). Respondents were asked to indicate on the EQ VAS the health states that are still acceptable for ages between 30 and 80 years in 10-year intervals (VAS acceptable health curve, AHC_vas). We recorded respondents' current health, health-related lifestyle, demographic background and explored the reference person they imagined when evaluating acceptable health states. We evaluated the AHC_vas by estimating linear multilevel models including a random intercept (estimated at age 30) and a random slope for age.

AHC_vas scores were available for 194 respondents (mean age = 42.8 years, range 19-93, 58% female). For ages of 30, 40, 50, 60, 70 and 80 years, mean AHC_vas scores were 93, 87, 80, 73, 65 and 57, respectively. The decline of AHC_vas was linear with age. Respondents' age, health status, lifestyle and health-related experiences, as well as their reference point taken (e.g. imagining themselves, others or both during the valuation task) influenced significantly the acceptability of health problems.

When measured with the EQ VAS, health problems were increasingly acceptable with age. Capturing well the individual variability in the assessment of acceptable health states at different ages, the EQ VAS is a useful addition to EQ-5D-3L descriptive system-based measures of acceptable health.