Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Aug 21, 2023
Date Accepted: May 30, 2024
Summary Measure of Health-related Quality of Life (HRQOL) with Its Related-factors Analysis Based on Chinese Version of Core Healthy Days Measures: A Cross-Sectional Study
ABSTRACT
Background:
The core Healthy Days measures were used to track the population-level health status in the Behavioral Risk Factor Surveillance System of China, however, they were not easily combined to summarize overall health-related quality of life (HRQOL) at the national level.
Objective:
This study developed a summary score based on Chinese version of core Health Days measures (HRQOL-5), and applied it to estimate HRQOL and its determinants in a Chinese population.
Methods:
From November 2018 to May 2019, a multi-stage stratified cluster survey was conducted to examine population health status and behavioral risk factors among resident population over 15 years old in Weifang, China. Both exploratory and confirmatory factor analyses (EFA and CFA) were performed to reveal underlying latent construct of HRQOL-5, and quantify the overall HRQOL via calculating its summary score. And Tobit regression models were finally carried out to identify the influencing factors of summary score.
Results:
A total of 26269 participants (male=51.7%, age=55.9±14.9) were taken into present study. 71% of respondents reported that they had excellent or very good general health. One summary factor was extracted to capture overall HRQOL using EFA. The CFA further confirmed this one-factor model (TLI, CFI and CFI=0.99, RMSEA=0.03). Multivariate Tobit regression analysis showed that age (β=-0.06), educational attainments (primary school, β=0.72; junior middle school, β=1.46; senior middle school or more, β=2.58), average income (30000 or more yuan, β=0.69), regular exercise (β=0.75), drank alcohol (β=0.103), self-reported disease (β=-6.36) and self-reported injure (β=-5.00) were the major influencing factors on the summary score of HRQOL-5.
Conclusions:
This study develops a summary score that summarized five HRQOL-5 items in a single variable, providing a more cohesive picture of HRQOL in population level. This summary score also could be used to estimate population-level of disability, calculating health-adjusted life expectancy in the future. In addition, differences in summary scores of different subpopulations may help set priorities for health planning in China to improve population HRQOL.
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