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Urban/rural differences in preferences for EQ-5D-5L health states: a study of a multi-ethnic region in China

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Abstract

Objectives

This study aimed to compare health preferences for EQ-5D-5L health states between urban and rural populations in China.

Methods

This study used pooled secondary data from two EQ-5D-5L valuation studies. Participants were recruited from Guizhou province and Chongqing municipality, China using quota sampling. Each participant was interviewed face-to-face to value a set of 15 or 16 out of 30 EQ-5D-5L health states using time trade-off (TTO) methods including composite TTO and other two variants. Regression analysis was used to compare health state preferences between urban and rural participants.

Results

A total of 597 participants (urban: 55.44%; rural: 44.56%) completed the valuation interviews. Both univariate and multivariable linear regression analyses showed that rural participants tended to value health states lower than urban participants regardless of severity of health states. The unadjusted and adjusted overall mean differences between the two groups were − 0.041 (95% confidence interval [CI] − 0.077, − 0.004, p-value = 0.031) and − 0.040 (95% CI − 0.078, − 0.002, p-value = 0.038), respectively. Predictions for the 3125 health states based on rural participants’ health preferences were lower than those based on urban participants’ health preferences.

Conclusion

There were small, yet statistically significant, differences in EQ-5D-5L health states preferences between urban and rural populations in China. Future study aiming at establishing a national value set should pay more attention to the sample representativeness.

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Data availability

The data that support the findings of this study are available from the corresponding author, Yang, Z., upon reasonable request.

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Funding

This work was supported by the EuroQol Research Foundation [grant numbers 2019050R1]. The funding agency had no role in the study implementation, analysis or interpretation of data, or preparation, review or approval of the manuscript.

Author information

Authors and Affiliations

  1. Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Meixia Liao & Nan Luo

  2. Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway

    Kim Rand

  3. Maths in Health B.V., Rotterdam, The Netherlands

    Kim Rand

  4. Health Services Management Department, Guizhou Medical University, Guiyang, China

    Zhihao Yang

Authors
  1. Meixia Liao
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  2. Nan Luo
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  3. Kim Rand
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  4. Zhihao Yang
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Contributions

ZY, NL and KR contributed to the study conception and design. Data analysis and interpretation were performed by ML, ZY and NL. The first draft of the manuscript was written by ML and ZY and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zhihao Yang.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study received exemption from the Guizhou Medical University Ethic Committee because this human subjects research qualifies as no risk or minimal risk to subjects and all of the research procedures fit within one of the exemption categories in Guizhou Medical University IRB regulations.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Not applicable.

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Liao, M., Luo, N., Rand, K. et al. Urban/rural differences in preferences for EQ-5D-5L health states: a study of a multi-ethnic region in China. Qual Life Res 32, 2329–2339 (2023). https://doi.org/10.1007/s11136-023-03394-1

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