Article

Quality of Life Research

, Volume 14, Issue 5, pp 1311-1320

First online:

Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey

  • Sheri L. MaddiganAffiliated withDepartment of Public Health Sciences, University of AlbertaInstitute of Health Economics
  • , David H. FeenyAffiliated withDepartment of Public Health Sciences, University of AlbertaInstitute of Health EconomicsDepartment of Economics, University of AlbertaHealth Utilities Inc.
  • , Jeffrey A. JohnsonAffiliated withDepartment of Public Health Sciences, University of AlbertaInstitute of Health EconomicsInstitute of Health Economics Email author 

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Abstract

Objective: To assess the impact of comorbid heart disease, stroke and arthritis on health-related quality of life (HRQL) in people with diabetes in the general Canadian population. Methods: Data were collected as part of the 1996–1997 Canadian National Population Health Survey. HRQL was assessed using overall Health Utilities Index Mark 3 (HUI3) and single attribute utility scores. Respondents (N=66,093) were classified into 1 of 16 groups based on the presence or absence of diabetes, heart disease, stroke, and arthritis, in all possible combinations and HRQL scores were compared using analysis of covariance. Results: Overall HUI3 scores for respondents with diabetes alone (0.88, 95 CI: 0.87–0.89) were lower than controls (0.92 95 CI: 0.92–0.92, p < 0.001). Overall HUI3 scores for diabetes in combination with␣heart disease (0.77, 95 CI: 0.74–0.79), arthritis (0.78, 95 CI: 0.77–0.79) or stroke (0.79, 95 CI: 0.74–0.85) were considerably lower than diabetes alone. Triplets of comorbidities were associated with overall HRQL deficits of approximately 0.26–0.30, relative to controls. Conclusions: The illness burden experienced by individuals with diabetes is not only associated with diabetes itself, but largely with comorbid medical conditions.

Keywords

Comorbidity Diabetes Health states Quality of life Population health Survey research