语境是不是很重要? 一个离散选择实验,调查息环境对EQ-5D-5L健康状况评估的影响
Irina Kinchin1, Peiwen Jiang2, Deborah Street2
1Centre for Health Policy and Management, Trinity College Dublin, College Green, Dublin, 2, Ireland. Irina.Kinchin@tcd.ie.
概括
使用EQ-5D的健康状况评估在考虑缓解护理需求时有所不同,例如有限的预期寿命. 特定背景的框架显著影响健康状况的估值,特别是与即时死亡相比.
科学领域:
- 卫生经济学 卫生经济学
- 抚慰性护理是一种缓解性护理.
- 衡量生活质量 衡量生活质量
背景情况:
- 准确的健康状况评估对于息治疗中的健康技术评估 (HTA) 至关重要.
- 现有的估值方法可能无法充分捕捉息护理背景的细微差别,可能导致资源配置效率低下.
研究的目的:
- 调查EQ-5D (EuroQol 5维) 健康状况的评估是否会在息护理背景下呈现时发生变化.
- 评估有限的预期寿命和支持可用性对健康状况评估的影响.
主要方法:
- 一个涉及澳大利亚,爱尔兰和英国一般人口样本的跨国横截式离散选择实验 (DCE).
- 参与者评估了20个选择组,将EQ-5D-5L健康状况与即时死亡进行比较,其中一半以无上下文的方式呈现,另一半以息护理视频呈现.
- 息护理需求被描述在四个不同的层面上,在上下文的细节中,以代方式开发. 用多项逻辑回归分析了数据.
主要成果:
- EQ-5D-5L健康状况评估在息护理背景下与无背景评估相比,显示出不一致性.
- 预期寿命和支持水平都影响了健康状况的评估,而预期寿命的影响更大.
- 息护理小贴士显著增加了被认为比死亡更糟糕的健康状况的数量,在澳大利亚和英国观察到的效果更大.
结论:
- 无上下文的EQ-5D值集在适用于息护理环境时需要仔细解释.
- 在息护理中对健康状况的评估对环境因素 (如预期寿命和支持可用性) 很敏感.
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