食管癌及其癌前病变人群健康效用值测量及影响因素
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摘要
目的测量食管癌患者及癌前病变人群的健康效用值状况,分析其影响因素,为提高该人群的健康相关生活质量提供依据。方法采用欧洲五维健康量表对健康相关生活质量进行测量,并按照中国积分体系转化为健康效用值。结果食管癌及癌前病变人群健康效用值P50(P25,P75)百分位数为0.869(0.770,1.000),自评健康得分为80.00(70.00,90.00)。健康效用值的影响因素包括:性别、职业、年收入和治疗阶段;自感健康评分的影响因素包括:家庭人口、文化程度、职业、医疗付费方式、病变分期、治疗方案和治疗阶段;且治疗方案与病变分期间均具有交互作用。结论健康效用值和自感健康评分从不同角度测量了受访人群的健康相关生活质量状况,且自感健康评分对于影响因素的测量更加敏感。关注无稳定工作和收入来源的患者,重视文化程度较高的患者的心理干预,着重改善处于Ⅲ期的食管癌患者的生活质量状况,将生活质量纳入患者治疗方案的选择标准之一;进一步完善社会保障水平和大病医疗保险等。
Objective To investigate the situation and influence factors of health utility scores among patients with oesophagus cancer and precancerosis,and provide evidence for valid promotion measures of health-related quality of life( HRQo L). Methods HRQo L was measured by European EQ-5D,and health utilities were achieved by Chinese Conversion Formula. Results The EQ-5D health utility percentiles was presented as P50( P25,P75) were 0. 869( 0. 770,1. 000) and the VAS scores were 80. 00( 70. 00,90. 00). The EQ-5D health utility scores were significantly influenced by gender,occupation,annual income and time points of treatment,while VAS scores were significantly influenced by number of family members,education levels,occupation,medical insurance,clinical stage,therapy methods and time points of treatment. The interaction was observed between therapy methods and clinical stage. Conclusion Health utility score and VAS measured the health-related quality of life of the interviewed population from different perspectives,while VAS was more sensitive to the measurement of influence factors. Attention should be paid to the population without a steady job and income,psychological interventions for patients with higher education levels should be emphasized,quality of life of patients with clinical stage Ⅲ should be greatly improved,the improvement of life quality should be put into the therapy regime,and further improve social security and serious illness medical insurance
Objective To investigate the situation and influence factors of health utility scores among patients with oesophagus cancer and precancerosis,and provide evidence for valid promotion measures of health-related quality of life( HRQo L). Methods HRQo L was measured by European EQ-5D,and health utilities were achieved by Chinese Conversion Formula. Results The EQ-5D health utility percentiles was presented as P50( P25,P75) were 0. 869( 0. 770,1. 000) and the VAS scores were 80. 00( 70. 00,90. 00). The EQ-5D health utility scores were significantly influenced by gender,occupation,annual income and time points of treatment,while VAS scores were significantly influenced by number of family members,education levels,occupation,medical insurance,clinical stage,therapy methods and time points of treatment. The interaction was observed between therapy methods and clinical stage. Conclusion Health utility score and VAS measured the health-related quality of life of the interviewed population from different perspectives,while VAS was more sensitive to the measurement of influence factors. Attention should be paid to the population without a steady job and income,psychological interventions for patients with higher education levels should be emphasized,quality of life of patients with clinical stage Ⅲ should be greatly improved,the improvement of life quality should be put into the therapy regime,and further improve social security and serious illness medical insurance
引文
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[2]CHEN S.The study of health related quality of life of patients with esophagus cancer[D].Journal of Nanjing Medical University,2016.
[3]LIU GG,WU H,LI M,et al.Chinese Time Trade-Off Values for EQ-5D Health States[J].Value in Health the Journal of the International Society for Pharmacoeconomics&Outcomes Research,2014,17(5):597-604.
[4]官海静,刘国恩.中国四地城乡居民生命质量的比较分析[J].中国卫生经济,2015,34(2):5-12.
[5]刘立煌,丁晗玥,严晓玲,等.居民健康相关生活质量的影响因素分析:基于北京市城市癌症早诊早治项目[J].公共卫生与预防医学,2017,28(05):6-10.
[6]胡晓,赵龙超,杨展,等.EQ-5D-3L两种积分效用体系对成都市城镇居民的适用性评价[J].公共卫生与预防医学,2017,28(06):27-30.
[7]Ferreira LN,Ferreira PL,Ribeiro FP,et al.Comparing the performance of the EQ-5D-3L and the EQ-5D-5L in young Portuguese adults[J].Health&Quality of Life Outcomes,2016,14(1):1-10.
[8]周挺,官海静,刘国恩,等.基于中国普通人群的EQ-5D-3L与EQ-5D-5L比较研究[J].中国卫生经济,2016(3).
[9]邢亚彬,马爱霞.欧洲五维健康量表EQ-5D-3L和EQ-5D-5L中文版比较的实证研究[J].上海医药,2013(7):27-31.
[10]王方舟,李洪超,马爱霞.效用量表在中国人群中的应用研究综述[J].中国药物评价,2015(4):244-247.
[11]Dreyfus J,Vietri J.Impact Of Burdensome Chronic Conditions On Health-Related Quality Of Life Among Europeans:Analysis Of Eq-5d-5l Vas Scores[J].Value in Health,2016,19(7):474-475.
[12]Malmstrom M,Klefsgard R,Ivarsson B,et al.Quality of life measurements as an indicator for timing of support after oesophagectomy for cancer:a prospective study[J].BMC Health Services Research,2015,15(1):1-7.