EQ-5D-5L population norms and health inequalities for Trinidad and Tobago

Abstract

The EQ-5D instrument is now used in many health systems as a health outcomes measure. Recently an EQ-5D valuation study was conducted for Trinidad and Tobago, but thus far there have been no population norms published for Trinidad and Tobago or for any Caribbean country. The objective of this study is to provide a set of population norms, and to investigate inequalities in health in Trinidad and Tobago. The EQ-5D-5L questionnaire was included in the 2012/2013 Adult Population Survey of the Global Entrepreneurship Monitor for Trinidad and Tobago. This survey covered a representative sample of 2,036 adults aged 18 and over. Demographic data and self-reported health using EQ-5D-5L were collected. The Trinidad and Tobago value set was used to obtain EQ-5D index values. The Kakwani index and logistic regression models were used to evaluate inequalities in health. Mean EQ-5D index values and EQ-VAS values were calculated by age group, ethnicity, gender, income, educational attainment, employment status and place of residence. The 10 most commonly observed EQ-5D-5L states accounted for 90% of the respondents. The mean VAS value for the sample was 83.6 and the mean EQ-5D-5L index value was 0.95. Pain/discomfort was found to be the EQ-5D dimension with the highest prevalence of reported problems with 22% of the population reporting pain at any level. Self-care was the dimension with the lowest prevalence of problems reported at any level (3%). Health declines with increasing age, and men reported fewer problems and higher levels of self-reported health than women. Age, gender and education level were found to be important drivers of health status as measured by the EQ-5D instrument. Being in a very low income group was also observed to affect EQ-VAS values among younger respondents. The population norms provided in this study can be used by clinicians, academics and policy makers in several ways. They can be used in comparing different demographic groups or patient groups, or as a basis for tracking the progress of patients through a treatment regimen. They can also provide a baseline for cost utility analysis of health interventions for Trinidad and Tobago.

Arthritis and Health Related Quality of Life in Adult Outpatients in Trinidad: A Cross Sectional Study

“…Pain and discomfort were found to be the dimension with the highest prevalence of reported problems with one fth of the adult population surveyed reporting pain at any level (27). In this study older age, female gender and lower educational level were also signi cant predictors of pain or discomfort (27). This may be explained by the higher burden of arthritis in older women as seen in this study.…”

EQ-5D-5L Slovenian population norms

“…In Slovenia the percentage of those reporting problems in AD is generally decreasing with age, up to the age of 40, and is lower in all age groups than in the youngest: similar situation is seen in China, Indonesia and for female in Italy. In comparison to Poland as the only other country in the same geographical area, such trend is not noticed and problems with AD dimension decrease with age [2,13,[20][21][22][23][24][25][26][27][28][29] (Figs. 4, 5, 6).…”

A Caribbean perspective: Quality of Life in Major Lower Extremity Amputees

“…Hence there has been quite an extensive investigation into this facet of the post-operative experience. The overall Quality of life in this study was determined to be below standard when compared to population norms for Trinidad and Tobago [4]. Additionally, individuals who ambulated with a prosthesis were found to have a better quality of life than those who did not.…”

“…This study demonstrated that amputees below the age of 50 years experienced a better quality of life than those over 50 years. These ndings are not surprising as Quality of life tends to decrease with advancing age [4]. Furthermore, older patients are more likely to have co-morbid conditions which can all contribute to delayed rehabilitation, affect mobility and therefore result in a poor quality of life.…”

“…Several studies have been performed evaluating various populations in an attempt to document standard population utility indices [28][29][30][31] Moreover, this is an international, validated health-related quality of life assessment tool, which an index value can be obtained and used to cross-reference with several other countries internationally [24]. The real value of using the EQ 5D tool is derived from the existing value indices for Trinidad and Tobago published by Bailey et al Although the population norm indices were obtained using the older version of the EQ 5D tool, this was easily overcome by translation of the EQ 5D-3L indices into the EQ 5D-5L equivalent [4,18]. There have been several of the statistical methods used for this purpose, which have been studied as well as validated internationally and has been deemed acceptable by the Euro QOL Study Group [17].…”