EQ-5D-5L新增认知维度用于贵州农村人群的效果及其价值探索  

Exploration on the effects and value of new cognitive dimension of EQ-5D-5L in rural population of Guizhou

作　　者：黄艳 伍红艳 杨智豪[2] 罗南 王龙[6] 林枭 郝兴敏 HUANG Yan;WU Hongyan;YANG Zhihao;LUO Nan;WANG Long;LIN Xiao;HAO Xingmin(School of Public Health,Guizhou Medical University,Guiyang 550025,China;School of Medical and Health Management,Guizhou Medical University,Guiyang 550025,China;Key Laboratory of Environmental Pollution and Disease Control of Ministry of Education,Guizhou Medical University,Guiyang 550025,China;Guizhou Institute of Health Development,Guiyang 550025,China;School of Public Health,National University of Singapore,Singapore 119077,Singapore;Dept.of Pathology,Guiqian International General Hospital,Guiyang 550025,China)

机构地区：[1]贵州医科大学公共卫生与健康学院,贵阳550025 [2]贵州医科大学医药卫生管理学院,贵阳550025 [3]贵州医科大学环境污染与疾病监控教育部重点实验室,贵阳550025 [4]贵州省卫生发展研究院,贵阳550025 [5]新加坡国立大学公共卫生学院,新加坡119077 [6]贵黔国际总医院病理科,贵阳550025

出　　处：《中国药房》2022年第2期203-208,共6页China Pharmacy

基　　金：贵州医科大学贵州省卫生发展研究院项目(No.gy-wf2020-20)。

摘　　要：目的为准确测量人群健康现状、开展药物经济学评价和指导卫生资源配置提供参考。方法采用配额及方便抽样法,于2020年7-9月在贵州省六枝特区、黔西市、剑河县下辖农村中各抽取5个行政村,基于全国人口普查结果中农村人群的性别和年龄比例配额抽取330例受访者进行问卷调查。问卷内容包括含社会人口学特征及一般健康信息的自制量表、增加了认知维度(包括注意力、记忆力、计算能力和学习能力)的五水平欧洲五维健康量表(EQ-5D-5L)(以下称为“新增维度量表”)及简易智能精神状态检查(MMSE)量表。考察新增维度量表的信度、效度和新增维度对受访者生命质量的影响,验证其测量特性,并探讨其在开展药物经济学评价及指导卫生资源配置中的应用价值。结果研究共发放问卷330份,回收问卷320份,均为有效问卷,回收率与有效率分别为96.97%、100%。新增维度量表的天花板效应为13.44%、分半信度系数为0.821、总体Cronbach’sα系数为0.852;探索性因子分析结果显示,新增维度量表可加载于生理、认知、心理3个因子,累计贡献率为69.35%;新增维度与MMSE量表维度的相关系数为0.19~0.61,呈中度或中至强相关(P<0.01)。相比EQ-5D-5L,新增各维度后回归模型的解释能力提高了5.00%~17.50%。结论新增维度量表可行性高、信效度良好,显著降低了EQ-5D-5L的天花板效应,对人群生命质量的测评敏感度更高,能够更好地测评农村人群的生命质量。建议可将其应用于生命质量评价、干预措施效果分析及相关经济性评价中。OBJECTIVE To provide reference for accurate measurement of population health status,pharmacoeconomic evaluation and guidance of health resource allocation.METHODS Using quota and convenient sampling,five administrative villages were selected from the rural areas under the jurisdiction of Liuzhi special zone,Qianxi city and Jianhe county of Guizhou province from July to September 2020.Based on the gender and age ratio quota of rural population in the results of the national census,330 respondents were selected for questionnaire survey.The contents of the questionnaire included the self-made scale containing sociodemographic characteristics and general health information,five-level EuroQoL five-dimension questionnaire(EQ-5D-5L,hereinafter referred to as the“new dimension scale”)with cognitive dimensions(including attention,memory,computing ability and learning ability)and mini-mental state examination(MMSE).The effects of reliability,validity and new dimensions of new dimension scale on respondents’quality of life were investigate,and its measurement characteristics were verified;the application value of it in pharmacoeconomic evaluation and guiding the allocation of health resources were explored.RESULTS A total of 330 questionnaires were distributed,320 were recovered and 320 were effective.The recovery rate and effective rate were 96.97%and 100%respectively.The ceiling effect of new dimension scale was 13.44%,the split-half reliability was 0.821,and the overall Cronbach’sαwas 0.852.Exploratory factor analysis showed that the new dimension scale was loaded with physiological,cognitive and psychological factors,and the cumulative contribution rate was 69.35%.The correlation coefficient between the new dimension and the dimension of MMSE scale were 0.19-0.61,showing a moderate or medium to strong correlation(P<0.01).Compared with EQ-5D-5L,after adding each dimension,the interpretation ability of the regression model was improved by 5.00%-17.50%.CONCLUSIONS The new dimension scale has high feasibility,good

关 键 词：五水平欧洲五维健康量表 认知 生命质量 农村人群 药物经济学 

分 类 号：R956[医药卫生—药学] R195