目的:健康偏好值与一个人的幸福状态有关,并且是锚定在0(死亡)和1(完美健康)的单个度量。健康偏好在卫生经济学和卫生政策中起着关键作用。特别是在解释成本效益研究的结果时,并支持医疗资源的分配。当前的研究使用了国际功能分类的要素,残疾与健康(ICF)框架,用于预测脊髓损伤(SCI)患者的健康偏好。
方法:数据是通过电话调查收集的(1)人口统计学,(2)损害(病因学,神经损伤程度,和ASIA减值量表),(3)二级健康状况(SHCs)使用SCI-二级健康状况量表修改,(4)使用脊髓独立性测量(SCIM)的功能能力,(5)在患有慢性SCI的成年人中使用健康效用指数-MarkIII(HUI-MarkIII)的健康偏好。根据ICF标题对变量进行分类,并使用分层回归分析来预测HUI-MarkIII评分。
结果:患有慢性创伤性或非创伤性SCI的成年人(N=357)报告的平均健康偏好评分为0.27(±0.27)。在预测健康偏好时,我们的模型占“身体功能和结构”方差的55.1%,和“活动和参与”,对模型有显著贡献(P<0.0001)。特别是,年龄较大,被雇用,SCIM评分较高与健康偏好呈正相关.相反,较高的SHC影响评分与较差的健康偏好相关.
结论:代表“活动和参与”的变量在很大程度上影响慢性SCI患者的健康偏好,这可能适合干预。这些发现可用于倡导健康促进和就业支持计划,以最大程度地提高社区慢性SCI患者的幸福感。
OBJECTIVE: Health preference values relate to a person\'s state of well-being, and is a single metric anchored at 0 (death) and 1 (perfect health). Health preference plays a key role in health economics and health policy, particularly in interpreting the results of cost-effectiveness studies, and supports the allocation of healthcare resources. The current study used elements of the International Classification of Functioning, Disability and Health (ICF) framework to predict health preference in persons with spinal cord injury (SCI).
METHODS: Data were collected by telephone survey on (1) demographics, (2) impairment (etiology, neurological level of injury, and ASIA impairment scale), (3) secondary health conditions (SHCs) using the SCI-Secondary Conditions Scale-Modified, (4) functional abilities using the Spinal Cord Independence Measure (SCIM), and (5) health preference using the Health Utilities Index-Mark III (HUI-Mark III) among adults with chronic SCI. Variables were categorized according to ICF headings and hierarchical regression analyses were used to predict HUI-Mark III scores.
RESULTS: Adults with chronic traumatic or non-traumatic SCI (N = 357) reported a mean health preference score of 0.27 (±0.27). In predicting health preference, our model accounted for 55.1% of the variance with \"body functions and structure\", and \"activity and participation\", significantly contributing to the model (P < 0.0001). In particular, older age, being employed, and having higher SCIM scores were positively associated with health preference. Conversely, a higher SHC impact score was associated with poorer health preference.
CONCLUSIONS: Variables representative of \"activity and participation\" largely influence health preference among persons with chronic SCI, which may be amenable to intervention. These findings could be applied to advocate for health promotion and employment support programs to maximize well-being in persons aging with chronic SCI in the community.