Population Norms and Disutility Catalog for Chronic Conditions in Sri Lanka

This study aimed to produce Sri Lankan population norms of utility values, EuroQol visual analog scale scores, and reported problems in each domain of the EQ-5D-5L, as well as a disutility catalog, based on a representative set of Sri Lankan preferences.

Data from a nationally representative sample of 6415 adults from the Sri Lanka Health and Ageing Study in 2018 to 2019 were used. Sri Lankan preferences were applied to EQ-5D-5L scores to produce utility values. Descriptive statistics were produced for responses by EQ-5D-5L dimension, mean utility values, and EuroQol visual analog scale scores, disaggregated by demographic and disease group. Multivariable logistic regression assessed associations with problems in each dimension, and demographic and chronic diseases. Robust ordinary least squares and tobit regressions were performed to estimate the marginal disutility of demographic covariates and disease conditions.

The mean utility value for the overall population was 0.867. Utility values decreased with age and increased with increasing education and richer socioeconomic quintiles. Males had higher utility values than females (0.89 vs 0.84; P < .001). Utility values declined by 0.007 with each year increase in age (P < .001) and statistically significant differences (P < .05) in utility were found by ethnicity, socioeconomic quintile, and disease conditions such as stroke, diabetes, cancer, depression, and musculoskeletal conditions, using a tobit regression.

This study provides the first nationally representative set of population norms based on a local value set for key demographic groups and selected chronic disease conditions for Sri Lanka. It also provides a catalog that can be easily used to calculate quality-adjusted life-years for cost-utility analysis when modeling public health interventions.