Predictors of EQ-5D-3L outcomes amongst injured Māori: 1-year post-injury findings from a New Zealand cohort study

Abstract

Purpose Māori, the Indigenous population of New Zealand (NZ), are at higher risk of problems with health-related quality of life (HRQoL) 12 months following injury. This paper examines pre-injury sociodemographic and health characteristics and injury-related factors, including healthcare access, and their association with HRQoL outcomes 12 months after injury. Methods The Prospective Outcomes of Injury Study recruited 2856 injured New Zealanders aged 18–64 years from the entitlement claims register of the country’s no-fault injury insurance agency. One-fifth (n = 566) of the cohort were Māori. Information on predictors and outcomes, with the exception of injury and hospitalisation, was obtained directly from participants at approximately 3 and 12 months post-injury. The outcomes of interest were responses to the five dimensions of the EQ-5D-3L and a dichotomous measure obtained by summing scored responses to each question. Modified Poisson regression was used to identify predictors of each outcome at 12 months post-injury. Results Predictors differed by outcome. Being female, experiencing EQ-5D-3L problems pre-injury, having ≥ 2 chronic conditions pre-injury, perceiving one’s injury to be a threat of long-term disability, and having trouble accessing health services for injury were common predictors of EQ-5D-3L problems at 12 months post-injury for Māori. Conclusion Opportunities exist to improve HRQoL outcomes by identifying individuals in the early stages of injury recovery who may benefit from further treatment and support.

Preference-based measures of health-related quality of life in Indigenous people: a systematic review

“…In some cases, the specific ethnicity beyond “Aboriginal” or “Indigenous” was not provided, however, the country is clearly stated. Among the included reports, only 26 described the methods used to determine ethnicity in the sample, such as self-report, or health records [ 10 – 12 , 35 , 42 , 45 , 48 – 50 , 53 , 55 , 57 , 61 , 63 , 69 , 73 , 75 , 89 , 95 , 98 – 100 ].…”

Health-related quality of life 12 years after injury: prevalence and predictors of outcomes in a cohort of injured Māori

“…Individuals who had ≥ 2 chronic conditions at the time of their injury were at greater risk of problems than those with none. This was the case for only usual activities and anxiety/depression at 12-months post-injury [ 51 ]. It may be that the burden of chronic conditions is now resulting in problems with mobility and self-care also, either through affecting recovery or simply via the cumulative impact of these conditions over time.…”

“…It may be that the burden of chronic conditions is now resulting in problems with mobility and self-care also, either through affecting recovery or simply via the cumulative impact of these conditions over time. Living arrangements, on the other hand, did not predict any HRQoL problems at 12 months post-injury [ 51 ] whereas those living with other people, in particular family members, prior to their injury were at lower risk of HRQoL problems at 12 years. It could be that this is a marker for the strength of peoples’ support networks and that those with greater support are less likely to encounter HRQoL problems, as has been found elsewhere (e.g., [ 52 ]).…”

“…At 12 months post-injury, pre-injury satisfaction with social relationships only protected against problems with self-care. We suggested these support networks may help individuals recover from injury but advised treating the finding with caution given there were only a small number of participants experiencing problems with self-care at 12 months [ 51 ]. It is also possible, however, that attrition at 12 years is the reason why satisfaction with social relationships did not protect against problems with self-care.…”

“…Those with a pre-injury BMI ≥ 30 were at greater risk of pain/discomfort than those with a BMI < 30. While we recommended treating findings regarding 12-month predictors of self-care problems with caution [ 51 ], BMI also predicted 12-month problems with self-care in the total cohort [ 56 ]. Previous studies have found an association between obesity and pain [ 57 , 58 ] and future problems with pain [ 59 – 61 ].…”