Gesundheitszustand bei Erwachsenen in Deutschland: Ergebnisse einer repräsentativen Befragung mit dem EuroQol 5D (EQ-5D)

Mielck, Andreas; Vogelmann, Martin; Schweikert, Bernd; Leidl, Reiner

doi:10.1055/s-0029-1239508

Cited by 25 publications

(17 citation statements)

References 17 publications

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“…This is also observed in previous studies [17,41,42,43]. Education cannot explain all valuation change but, if the educational distribution of a similar study from 2006 [18], in which the proportion of participants with low education was 7.3 percentage points higher than in this study, were to be applied to the explanatory VAS model in this study, the VAS mean for the entire study population would be slightly lower at 84.7 (vs. 79.2 in 2006).…”

Section: Discussionsupporting

confidence: 79%

“…However, the descriptive system of the EQ-5D-3L is less differentiated than the 5L answer version. An earlier study by W&B Verlag reported a VAS mean of 79.2 for a study population with 54.4% women and an average age of 46.4 years in 2006 [18,19]. In addition to the increase in HRQoL since 2006 shown in comparison with VAS values in this study, surveys by the Bertelsmann Gesundheitsmonitor [47] indicate a considerable improvement in satisfaction with health care provision.…”

Section: Discussionsupporting

confidence: 61%

“…Our dataset is based on an annual survey of the general German population conducted by the IFAK research institute [16,17,18,19] on behalf of Wort & Bild Verlag (W&B). The survey’s goal is to gather information regarding trends in health care, but the survey also includes questions on the health status of the German population.…”

Section: Methodsmentioning

confidence: 99%

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Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L

Huber

Felix

Vogelmann³

et al. 2017

IJERPH

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The EQ-5D-5L is a widely used generic instrument to measure health-related quality of life. This study evaluates health perception in a representative sample of the general German population from 2015. To compare results over time, a component analysis technique was used that separates changes in the description and valuation of health states. The whole sample and also subgroups, stratified by sociodemographic parameters as well as disease affliction, were analyzed. In total, 2040 questionnaires (48.4% male, mean age 47.3 year) were included. The dimension with the lowest number of reported problems was self-care (93.0% without problems), and the dimension with the highest proportion of impairment was pain/discomfort (71.2% without problems). Some 64.3% of the study population were identified as problem-free. The visual analog scale (VAS) mean for all participants was 85.1. Low education was connected with significantly lower VAS scores, but the effect was small. Depression, heart disease, and diabetes had a strong significant negative effect on reported VAS means. Results were slightly better than those in a similar 2012 survey; the most important driver was the increase in the share of the study population that reported to be problem-free. In international comparisons, health perception of the general German population is relatively high and, compared with previous German studies, fairly stable over recent years. Elderly and sick people continue to report significant reductions in perceived health states.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 61%

See 1 more Smart Citation

Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L

Huber

Felix

Vogelmann³

et al. 2017

IJERPH

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“…The analyses were restricted to participants who were at least 20 years of age, as school education (our main independent variable) should be finished by this age. The surveys comprise a face-to-face interview and a self-administered questionnaire for the EQ-5D-3 L. Previous publications based on other parts of these data describe the distribution of HRQL in Germany [45] and the basic associations with educational level [2]. The data have also been used to develop a new method estimating a value set for the EQ-5D-3 L based on health states experienced [46].…”

Section: Methodsmentioning

confidence: 99%

Health-related quality of life and socioeconomic status: inequalities among adults with a chronic disease

Mielck

Vogelmann²,

Leidl

2014

Health and Quality of Life Outcomes

157

103

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BackgroundA number of studies have shown an association between health-related quality of life (HRQL) and socioeconomic status (SES). Indicators of SES usually serve as potential confounders; associations between SES and HRQL are rarely discussed in their own right. Also, few studies assess the association between HRQL and SES among those with a chronic disease. The study focuses on the question of whether people with the same state of health judge their HRQL differently according to their SES, and whether a bias could be introduced by ignoring these differences.MethodsThe analyses were based on a representative sample of the adult population in Germany (n = 11,177). HRQL was assessed by the EQ-5D-3 L, i.e. the five domains (e.g. ‘moderate or severe problems’ concerning mobility) and the Visual Analog Scale (VAS). SES was primarily assessed by educational level; age, sex and family status were included as potential confounders. Six chronic diseases were selected, each having a prevalence of at least 1% (e.g. diabetes mellitus). Multivariate analyses were conducted by logistic and linear regression.ResultsAmong adults with a chronic disease, most ‘moderate or severe problems’ are reported more often in the low (compared with the high) educational group. The same social differences are seen for VAS values, also in subgroups characterized by ‘moderate or severe problems’. Gender-specific analyses show that for women the associations with VAS values can just be seen in the total sample. For men, however, they are also present in subgroups defined by ‘moderate or severe problems’ or by the presence of a chronic disease; some of these differences exceed 10 points on the VAS scale.ConclusionsLow SES groups seem to be faced with a double burden: first, increased levels of health impairments and, second, lower levels of valuated HRQL once health is impaired. These associations should be analysed and discussed in their own right, based on interdisciplinary co-operation. Social epidemiologists could include measures of HRQL in their studies more often, for example, and health economists could consider assessing whether recommendations based on HRQL scales might include a social bias.

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“…Health state specific utilities were thus applied as a multiplicative factor to average, age-adjusted utilities from the German male population. The latter are based on a representative study among German citizens (n = 2,049) surveying the EQ-5D items in the years 2006-2011 [27]. Based on these data, the functional relationship between mean EQ-5D utilities and age was estimated with a generalised additive regression model using cubic regression splines (Figure 2) [25].…”

Section: Methodsmentioning

confidence: 99%

The cost-utility of open prostatectomy compared with active surveillance in early localised prostate cancer

Koerber

Waidelich

Stollenwerk

et al. 2014

BMC Health Serv Res

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BackgroundThere is an on-going debate about whether to perform surgery on early stage localised prostate cancer and risk the common long term side effects such as urinary incontinence and erectile dysfunction. Alternatively these patients could be closely monitored and treated only in case of disease progression (active surveillance). The aim of this paper is to develop a decision-analytic model comparing the cost-utility of active surveillance (AS) and radical prostatectomy (PE) for a cohort of 65 year old men with newly diagnosed low risk prostate cancer.MethodsA Markov model comparing PE and AS over a lifetime horizon was programmed in TreeAge from a German societal perspective. Comparative disease specific mortality was obtained from the Scandinavian Prostate Cancer Group trial. Direct costs were identified via national treatment guidelines and expert interviews covering in-patient, out-patient, medication, aids and remedies as well as out of pocket payments. Utility values were used as factor weights for age specific quality of life values of the German population. Uncertainty was assessed deterministically and probabilistically.ResultsWith quality adjustment, AS was the dominant strategy compared with initial treatment. In the base case, it was associated with an additional 0.04 quality adjusted life years (7.60 QALYs vs. 7.56 QALYs) and a cost reduction of €6,883 per patient (2011 prices). Considering only life-years gained, PE was more effective with an incremental cost-effectiveness ratio of €96,420/life year gained. Sensitivity analysis showed that the probability of developing metastases under AS and utility weights under AS are a major sources of uncertainty. A Monte Carlo simulation revealed that AS was more likely to be cost-effective even under very high willingness to pay thresholds.ConclusionAS is likely to be a cost-saving treatment strategy for some patients with early stage localised prostate cancer. However, cost-effectiveness is dependent on patients’ valuation of health states. Better predictability of tumour progression and modified reimbursement practice would support widespread use of AS in the context of the German health care system. More research is necessary in order to reliably quantify the health benefits compared with initial treatment and account for patient preferences.

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Gesundheitszustand bei Erwachsenen in Deutschland: Ergebnisse einer repräsentativen Befragung mit dem EuroQol 5D (EQ-5D)

Cited by 25 publications

References 17 publications

Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L

Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L

Health-related quality of life and socioeconomic status: inequalities among adults with a chronic disease

The cost-utility of open prostatectomy compared with active surveillance in early localised prostate cancer

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