在无残疾和质量调整的预期寿命之间明显的社会不平等差异
Ieva Skarda1, James Lomas1, Richard Cookson1
1Centre for Health Economics, University of York, Heslington, YO10 5DD, UK.
概括
与连续调整相比,二进制调整高估了健康不平等. 调整无残疾和健康预期寿命的尺度,使它们更容易与质量调整的预期寿命进行比较,改善健康公平分析.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
- 社会流行病学 社会流行病学
背景情况:
- 与健康相关的生活质量 (HRQOL) 的调整显著影响健康方面的社会不平等估计.
- 分布性成本效益分析 (DCEA) 依赖于对健康不平等的准确测量,以获得公平权重.
- 在二进制和连续HRQOL调整之间做出选择可以影响有关健康公平的政策相关结论.
研究的目的:
- 调查二进制与连续HRQOL调整如何影响终身健康社会不平等的估计.
- 探索这些调整对DCEA内部股权权重的影响.
- 为了比较不同的预期寿命指标,包括质量调整预期寿命 (QALE),无残疾预期寿命 (DFLE) 和健康预期寿命 (HLE).
主要方法:
- 利用了2018年英格兰健康调查和ONS死亡率/人口数据.
- 对QALE (EQ-5D-5L),DFLE (限制长期疾病) 和HLE (自我评估健康) 的社区贫困五分位数的健康分布进行比较.
- 通过使用阿特金森不平等厌恶参数和按年龄和贫困进行交叉表格 HRQOL 来得的间接股权权重.
主要成果:
- 与二进制调整相比,连续调整显示了最贫困和最贫困的五分位数之间的不平等差距较小 (QALE: 11.25,DFLE: 16.00,HLE: 18.53).
- 二元调整导致股权权重大幅增加,特别是在更高的不平等厌恶水平下.
- 社会群体的HRQOL差异是由患病率和其负担驱动的,患病率是最大的因素.
结论:
- 无残疾和健康预期寿命指标显示,由于它们的二进制缩放,估计的健康不平等比质量调整的预期寿命更大.
- 二进制缩放隐含地为残疾或健康状况不佳赋予了零HRQOL值,类似于死亡.
- 简单地对二进制尺度的终点进行调整,可以提高这些措施之间的可比性,并改善健康公平评估.
关键词:
EQ-5D-3L EQ-5D-3L EQ-5D-3L EQ-5D-3L EQ-5D-3L EQ-5D-3L EQ-5D-3在 EQ-5D-5L 中.卫生公平性健康公平性健康的预期寿命 健康的预期寿命不平等的厌恶 不平等的厌恶经质量调整的寿命年数.更多相关视频
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