Quality of Life Research

, Volume 20, Issue 6, pp 825–832

Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States

Article

DOI: 10.1007/s11136-010-9819-x

Cite this article as:
Fu, A.Z., Qiu, Y., Radican, L. et al. Qual Life Res (2011) 20: 825. doi:10.1007/s11136-010-9819-x
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Abstract

Purpose

To examine and quantify, at the US national level, the marginal differences in health-related quality of life (HRQoL) of diabetic patients with and without macrovascular comorbid conditions (MaVCC).

Methods

Using the pooled Medical Expenditure Panel Survey (MEPS) 2001 and 2003 data, a nationally representative community-dwelling adult sample (age ≥ 18) was included in the study. HRQoL measures included the preference-based EQ-5D index, Euroqol visual analogue scale (EQ-VAS), SF-12 physical component summary (PCS), and SF-12 mental component summary (MCS). Given the censored distribution of the data, a two-part model was used to identify the relationship between MaVCC and the EQ-5D index after controlling for age, sex, race, ethnicity, education, income, employment status, health insurance, smoking status, diabetes severity, and comorbidities. Censored least absolute deviation and ordinary least square models were employed to analyze EQ-VAS and SF-12 PCS/MCS, respectively.

Results

Compared to diabetic patients without MaVCC (N = 2431), those with MaVCC (N = 747) had significantly lower EQ-5D index (−0.062), EQ-VAS (−9.2), SF-12 PCS (−5.0), and MCS (−2.1) after controlling for differences in sociodemographics, smoking status, diabetes severity, and comorbidities (all P < 0.001).

Conclusions

MaVCC is consistently associated with lower HRQoL for patients with diabetes in the United States. Results of this study are valuable for future comparative-effectiveness and cost-effectiveness analyses in diabetes.

Keywords

DiabetesHealth-related quality of lifeCardiovascular diseaseEQ-5D

Abbreviations

AHRQ

Agency for Healthcare Research and Quality

CCCs

Clinical classification categories

CLAD

Censored least absolute deviations estimator

EQ-VAS

Euroqol visual analogue scale

HRQoL

Health-related quality of life

HUI-3

Health Utilities Index Mark 3

MaVCC

Macrovascular comorbid conditions

MCS

Mental component summary

MEPS

Medical Expenditure Panel Survey

OLS

Ordinary least square

PCS

Physical component summary

QALYs

Quality-adjusted life years

QWB-SA

Self-Administered Quality of Well Being

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Department of Quantitative Health SciencesCleveland ClinicClevelandUSA
  2. 2.Global Outcomes Research, Merck & Co., Inc.Whitehouse StationUSA
  3. 3.Department of Epidemiology and Public Health & Centre for Health Services Research, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore