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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
How do Zimbabweans value health states?
Population Health Metrics, Volume 1, Article 11, Year 2003
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Description
Background . Quality of life weights based on valuations of health states are often used in cost utility analysis and population health measures. This paper reports on an attempt to develop quality of life weights within the Zimbabwe context. Methods. 2,384 residents in randomly selected small residential plots of land in a high-density suburb of Harare valued descriptors of 38 health states based on different combinations of the five domains of the EQ-5D (mobility, self-care, usual activities, pain or discomfort and anxiety or depression). The English version of the EQ-5D was used. The time trade-off method was used to determine the values, and 19,020 individual preferences for health states were analysed. A residual maximum likelihood linear mixed model was used to estimate a function for predicting the values of all possible combinations of levels on the five domains. The model was fit to a random subset of two-thirds of the observations, with the remaining observations reserved for analysis of predictive validity. The results were compared to a similar study undertaken in the United Kingdom. Results. A credible model was developed to predict the values of states that were not valued directly. In the subset of observations reserved for validation, the mean absolute difference between predicted and observed values was 0.045. All domains of the EQ-5D were found to contribute significantly to the model, both at the moderate and severe levels. Severe pain was found to have the largest negative coefficient, followed by the inability to wash and dress oneself. Conclusion. Despite a generally lower education level than their European counterparts, urban Zimbabweans appear to value health states in a consistent manner, and the determination of a global method of establishing quality of life weights may be feasible and valid. However, as the relative weightings of the different domains, although correlated, differed from the standard set of weights recommended by the EuroQol Group, the locally determined coefficients should be used within the Zimbabwean context. © 2003 Jelsma et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC317383/bin/1478-7954-1-11-S1.doc
Authors & Co-Authors
Jelsma, Jennifer M.
South Africa, Cape Town
University of Cape Town
Hansen, Kristian Schultz
Denmark, Copenhagen
Københavns Universitet
de Weerdt, Willy J.G.
Belgium, Leuven
Ku Leuven
de Cock, Paul P.
Belgium, Leuven
Ku Leuven
Kind, Paul
United Kingdom, York
University of York
United States, Madison
University of Wisconsin-madison
Statistics
Citations: 142
Authors: 5
Affiliations: 5
Identifiers
Doi:
10.1186/1478-7954-1-11
ISSN:
14787954
Research Areas
Disability
Mental Health
Study Design
Cross Sectional Study
Study Locations
Zimbabwe