EQ-5D-5L Slovenian population norms Prevolnik Rupel, Valentina; Ogorevc, Marko
Health and quality of life outcomes,
10/2020, Letnik:
18, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The study aims to present Slovenian EQ-5D-5L population norms for different age and gender subgroups that can be used as reference values in future studies concerning health status. The secondary aim ...is to compare those norms with population norms from some other countries in Europe and elsewhere.
The cross-sectional survey was conducted between November 2019 and February 2020 via online panel. 1071 adults aged 18+ were included in the survey. The general population was sampled using quota sampling in terms of age, gender, and NUTS2 region. In the study, the EQ-5D-5L Slovenian online version was used. Descriptive statistics was used to present health status by age groups and genders for the EQ-5D-5L descriptive system, EQ VAS and the EQ-5D-5L index score. The latter was derived from Slovenian EQ-3D-3L tariff, transformed to five levels using the crosswalk methodology.
The mean EQ VAS score in the Slovenian population was 79.9, mean utility index was 0.808. 28.2% of the population did not have problems on any dimension and 3.9% of the population had problems on all dimensions. Persons residing in Western Slovenia had, on average, 0.016 higher utility score, compared to Eastern Slovenia. Effect of gender was not significant. Age was negatively associated with both utility index and EQ VAS score. Education was positively correlated to health status. Problems on dimensions were generally increasing with age, except for anxiety/depression dimension, where youngest group (ages 18-29) reported more anxiety/depression compared to older counterparts. Self-reported anxiety/depression was more pronounced in women.
Similarly to other countries, the health generally deteriorates with age, except for the anxiety/depression dimension where the share of respondents reporting no problems was lowest in the youngest age group. The open question for the future remains, whether population norms from this online sample differ significantly from the actual EQ-5D-5L health status data of the Slovenian general population.
EQ-5D-5L Value Set for Slovenia Prevolnik Rupel, Valentina; Ogorevc, Marko
PharmacoEconomics,
11/2023, Letnik:
41, Številka:
11
Journal Article
Recenzirano
Odprti dostop
Objectives
The aim of this valuation study was to produce a value set to support the use of EQ-5D-5L data in decision making in Slovenia.
Methods
The study design followed the published EuroQol ...research protocol, and a quota sample was defined according to age, sex, and region. Overall, 1012 adult respondents completed 10 time trade-off and seven discrete choice experiment tasks in face-to-face interviews. The Tobit model was used to analyse the composite time trade-off (cTTO) data in order to generate values for the 3125 EQ-5D-5L health states.
Results
The data showed logical consistency, with more severe states being given lower values. The greatest disutility was shown in the pain/discomfort and anxiety/depression dimensions. In the EQ-5D-5L value set, the values range from −1.09 to 1. With the exception of UA5 (unable to perform usual activities), all other levels on all health dimensions were statistically different from 0 and from each other. Compared with the existing EQ-5D-3L value set, there is a slightly lower share of ‘worse than dead’ states (32.1% compared with 33.7%) and the minimum value is lower.
Conclusions
Results have important implications for users of the EQ-5D-5L in Slovenia and regions. It is a robust and up-to-date value set and should be the preferred value set used in adults in Slovenia and in neighbouring countries without their own value set.
EQ-5D-Y Value Set for Slovenia Prevolnik Rupel, Valentina; Ogorevc, Marko
PharmacoEconomics,
04/2021, Letnik:
39, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Background
A value set for the EuroQoL 5-Dimensions (EQ-5D)-Y in Slovenia is not yet available, making the calculation of quality-adjusted life-years (QALYs) for children and adolescents using this ...generic instrument impossible.
Objective
The main objective of our study was to obtain adult preferences towards EQ-5D-Y health states in Slovenia, following the EQ-5D-Y-3L international valuation protocol. The adults were asked to take the perspective of a hypothetical 10-year-old child.
Method
A sample of 1074 adults in Slovenia completed an online discrete-choice experiment (DCE) survey on EQ-5D-Y health states. The latent scale issue was addressed by obtaining the value of the anchor (33333) with 200 composite time trade-off (cTTO) interviews. A mixed (random coefficients) logit model was used to estimate the value set.
Results
All the estimated coefficients of the mixed logit model were statistically significant at the 1% level and had an expected negative sign. The most important health dimension in EQ-5D-Y is pain/discomfort, followed by anxiety/depression, usual activities, and mobility, with self-care being the least important health dimension.
Conclusions
The study addresses an important research gap and presents the EQ-5D-Y value set for Slovenia. At the time of writing, no published value sets are available for the EQ-5D-Y-3L appropriate for use in QALY calculations, making this value set the first EQ-5D-Y value set in the world.
The two primary objectives of this paper were (a) to develop first logically consistent TTO based EQ-5D-3L value sets for Slovenia and (b) to revisit earlier developed VAS based EQ-5D-3L value sets.
...Between September 2005 and April 2006, face-to-face interviews with 225 individuals in Slovenia were conducted. Protocols from the Measurement and Value of Health study were followed closely. Each respondent valued 15 health states out of a total of 23. Model selection was informed by the criteria monotonicity/logical consistency. Predictive accuracy was assessed in terms of mean square difference between out-of-sample predictions and corresponding observed means, as well as Lin's Concordance Correlation Coefficient.
Modelling was based on 2,717 VAS and 2,831 TTO values elicited from 225 respondents. A 6-parameter constrained regression model with a supplementary power term was selected for VAS and TTO value sets, as it produces monotonic values, and proved superior in terms of out-of-sample predictive accuracy over the tested alternatives.
This is the first EQ-5D-3L TTO based value set in Slovenia and the second in Central and Eastern Europe (besides Poland). It is also the first monotonic and logically consistent VAS value set in Central and Eastern Europe. Comparisons with Polish and UK TTO values show considerable differences, mostly due to mobility with having a substantially greater weight in Slovenia. The UK value set generally produces lower values and the Polish value set higher values for mild states.
Do we have the spark? Rupel, Valentina Prevolnik; Marušič, Dorijan
Zdravstveno varstvo,
06/2022, Letnik:
61, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Upgrading any system is challenging. Neglecting continuous monitoring and evaluation might impose solutions that worsen the situation. Primary orientation toward increasing productivity is the main ...reason for the tremendous decline in the accessibility of outpatient services in Slovenia since 2015, in addition to additional funds from the state budget. In the actual ‘fee-for-service’, providers are incentivised to deliver more expensive services, not first visits. Although the stakeholders are not to blame, it is high time for an orientation towards patients’ needs: a breakaway from inefficient technical solutions, an acceptance of patients as active participants in decision-making, measurement of their treatment outcomes, and the adoption of already proven advanced payment models, such as population-based payments. The journey towards value-based healthcare must start!
Due to the availability of the EQ-5D-5L instrument official translation into Slovenian its use is widespread in Slovenia. However, the health profiles obtained in many studies cannot be ascribed ...their appropriate values as the EQ-5D-5L value set does not yet exist in Slovenia. Our aim was to estimate an interim EQ-5D-5L value set for Slovenia using the crosswalk methodology developed by the EuroQol Group on the basis of the EQ-5D-3L Slovenian TTO value set. Our secondary aim was to compare the interim values obtained with the EQ-5D-3L Slovenian values.
To obtain a Slovenian interim EQ-5D-5L value set, we applied the crosswalk methodology developed by the EuroQol Group to the Slovenian EQ-5D-3L TTO value set. We examined the differences between values by comparing the mean 3L and 5L value scores and the distribution of values across all respondents.
By definition, 3-level and 5-level versions have the same range (from 1 to -0.495) and a health state coded 22222 in the 3-level version corresponds to 33333 in the 5-level version. While the addition of a "slight" severity level (22222) in the 5-level version has a low informational value, the addition of a "severe" health state (44444) covers larger range of the scale. The 5-level version results in fewer health states being valued below 0 and above 0.8.
The EQ-5D-5L value set, based on the crosswalk methodology, should be used until a value set for the EQ-5D-5L is derived from preferences elicited directly from a representative sample of the Slovenian general population.
is a very old saying, originating from England in the mid-to late 1800s. However, despite being in use for more than two centuries, its meaning is still not fully grasped in Slovenian healthcare. ...While we claim that the healthcare system serves the patient and that the care provided is patient-centred, we do not even measure the treatment outcomes that matter to patients. Without measuring these, we do not know whether the treatment provided value to the patients, i.e. what were the benefits of the treatment relative to the costs. Slovenian payment models do not reimburse the providers for created patient-relevant value, but rather for the planned number of services or cases based on average incurred costs. It is thus time to digitalise the system, and start collecting, curating and analysing the relevant data to ensure that all stakeholders within the healthcare system co-deliver value to patients. While relevant stakeholders highlight notable challenges of implementing value-based healthcare in Slovenia, these are far from insurmountable.
EQ-5D in Central and Eastern Europe: 2000-2015 Rencz, Fanni; Gulácsi, László; Drummond, Michael ...
Quality of Life Research,
11/2016, Letnik:
25, Številka:
11
Journal Article, Book Review
Recenzirano
Odprti dostop
Objective Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to ...generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. Methods An electronic database search was performed up to 1 July 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets. Results We identified 143 studies providing 152 countryspecific results with a total sample size of 81,619: Austria (n = 11), Bulgaria (n = 6), Czech Republic (n = 18), Hungary (n = 47), Poland (n = 51), Romania (n = 2), Slovakia (n = 3) and Slovenia (n = 14). Cardiovascular (21 %), neurologic (17 %), musculoskeletal (15 %) and endocrine, nutritional and metabolic diseases (13 %) were the most frequently studied clinical areas. Overall, 112 (78 %) of the studies reported EQ VAS results and 86 (60 %) EQ-5D index scores, of which 27 (31 %) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set. Conclusions Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened.
Measurements of health-related quality of life (HRQoL) among celiac disease patients using a validated questionnaire have been lacking in Slovenia. This study aims to measure HRQoL in celiac disease ...(CD) patients using EQ-5D internationally validated questionnaire and comparing it to the HRQoL of the general population.
In this cross sectional analysis all of the approximately 2000 members of the Slovenian Celiac Society were invited to take part. We used a 3 step approach for recruitment and data collection. HRQoL was evaluated through the EuroQoL EQ-5D-5L instrument (Slovenian version) and analysed using the ordinal logistic regression.
Out of 321 patients who gave their consent, 247 celiac patients were included in the study (77%). 68% of the participants were female and 53% of them lived in an urban setting. Most patients originated from North-East Slovenia, whereas approximately 30% of patients came from other Slovenian regions. The EQ-5D respondents' self-reported health status at the time of the study show that most patients have slight or no problems when living with CD. The duration of the gluten-free diet, academic education and rare (< 1 × year) doctor visits affect EQ-5D in a positive way. On the other hand, higher age and chronic rheumatic disease were negatively associated with EQ-5D also when compared to the general population.
This is the first Slovenian study to measure the HRQoL of Slovenian CD patients, using an internationally validated questionnaire. The results of our study show that HRQoL is slightly impaired among Slovenian patients with CD. Clinical characteristics are better determinants of their HRQoL than socio-demographic factors. Greater awareness of the impact of CD on patients' HRQoL would improve the holistic management of CD patients.
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