Quality of Life Research

, Volume 25, Issue 5, pp 1313–1321 | Cite as

Normative values of EQ-5D-5L: in a Spanish representative population sample from Spanish Health Survey, 2011

  • M. A. Garcia-Gordillo
  • J. C. Adsuar
  • P. R. Olivares
Brief Communication



To derive EQ-5D-5L Spanish population norms based on a national representative sample adjusted by age, gender and region.


A representative sample of the Spanish general population (n = 21,007) was used in a cross-sectional study. The source of data was the Spanish National Health Survey 2011–2012. All socio-demographic factors and clinical characteristics were carried to a descriptive analysis. All variables were stratified by region, gender and age-group.


The utility value 1 is the most repeated (62 %) in this representative population sample. This study showed a deterioration of health states as age increases. Overall, men reported better health status than women. In relation to ceiling effect by regions, there was little difference with the highest scores. Conversely, the lowest score corresponds to Galicia.


The paper reports EQ-5D-5L normative data for Spanish general population, based on a national representative sample adjusted by region, gender and age-group. These results may serve as reference data of the population health status. A regional difference in health status could be observed, which might suggest that policies aiming to reduce regional inequalities are important.


HRQoL instrument EQ-5D-5L Cross-walk Utility Normative values Spain 


  1. 1.
    Badia, X., Roset, M., Montserrat, S., Herdman, M., & Segura, A. (1999). La versión española del EuroQol: Descripción y aplicaciones. Medicina Clinica, 112, 79–85.PubMedGoogle Scholar
  2. 2.
    Lubetkin, E. I., Jia, H., Franks, P., & Gold, M. R. (2005). Relationship among sociodemographic factors, clinical conditions, and health-related quality of life: Examining the EQ-5D in the US general population. Quality of Life Research, 14(10), 2187–2196.CrossRefPubMedGoogle Scholar
  3. 3.
    Hurst, N., Kind, P., Ruta, D., Hunter, M., & Stubbings, A. (1997). Measuring health-related quality of life in rheumatoid arthritis: Validity, responsiveness and reliability of EuroQol (EQ-5D). Rheumatology, 36(5), 551–559.CrossRefGoogle Scholar
  4. 4.
    Janssen, M., Lubetkin, E., Sekhobo, J., & Pickard, A. (2011). The use of the EQ-5D preference-based health status measure in adults with Type 2 diabetes mellitus. Diabetic Medicine, 28(4), 395–413.CrossRefPubMedGoogle Scholar
  5. 5.
    Sun, S., Chen, J., Kind, P., Xu, L., Zhang, Y., & Burström, K. (2014). Experience-based VAS values for EQ-5D-3L health states in a national general population health survey in China. Quality of Life Research, 24(3), 693–703.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Herdman, M., Gudex, C., Lloyd, A., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Jia, Y. X., Cui, F. Q., Li, L., et al. (2014). Comparison between the EQ-5D-5L and the EQ-5D-3L in patients with hepatitis B. Quality of Life Research, 23(8), 2355–2363.CrossRefPubMedGoogle Scholar
  8. 8.
    Janssen, M. F., Pickard, A. S., Golicki, D., et al. (2013). Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: A multi-country study. Quality of Life Research, 22(7), 1717–1727.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Greene, M. E., Rader, K. A., Garellick, G., Malchau, H., Freiberg, A. A., & Rolfson, O. (2014). The EQ-5D-5L improves on the EQ-5D-3L for health-related quality-of-life assessment in patients undergoing total hip arthroplasty. Clinical Orthopaedics and Related Research473(11), 3383–90.CrossRefGoogle Scholar
  10. 10.
    Pan, C. W., Sun, H. P., Wang, X., et al. (2014). The EQ-5D-5L index score is more discriminative than the EQ-5D-3L index score in diabetes patients. Quality of Life Research, 24(7), 1767–74.CrossRefPubMedGoogle Scholar
  11. 11.
    Janssen, M. F., Birnie, E., Haagsma, J. A., & Bonsel, G. J. (2008). Comparing the standard EQ-5D three-level system with a five-level version. Value in Health, 11(2), 275–284.CrossRefPubMedGoogle Scholar
  12. 12.
    Pickard, A. S., De Leon, M. C., Kohlmann, T., Cella, D., & Rosenbloom, S. (2007). Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Medical Care, 45(3), 259–263.CrossRefPubMedGoogle Scholar
  13. 13.
    van den Berg, B. (2012). Sf-6d population norms. Health Economics, 21(12), 1508–1512.CrossRefPubMedGoogle Scholar
  14. 14.
    Norman, R., Church, J., van den Berg, B., & Goodall, S. (2013). Australian health-related quality of life population norms derived from the SF-6D. Australian and New Zealand Journal of Public Health, 37(1), 17–23.CrossRefPubMedGoogle Scholar
  15. 15.
    Szende, A., & Williams, A. (2004). Measuring self-reported population health: An international perspective based on EQ-5D. Rotterdam: EuroQol Group. SpringMed Publishing.Google Scholar
  16. 16.
    Ferreira, L. N., Ferreira, P. L., Pereira, L. N., & Oppe, M. (2014). EQ-5D Portuguese population norms. Quality of Life Research, 23(2), 425–430.CrossRefPubMedGoogle Scholar
  17. 17.
    König, H., Bernert, S., & Angermeyer, M. (2005). Health Status of the German population: Results of a representative survey using the EuroQol questionnaire. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)), 67(3), 173–182.CrossRefGoogle Scholar
  18. 18.
    Sun, S., Chen, J., Johannesson, M., et al. (2011). Population health status in China: EQ-5D results, by age, sex and socio-economic status, from the National Health Services Survey 2008. Quality of Life Research, 20(3), 309–320.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Hinz, A., Kohlmann, T., Stöbel-Richter, Y., Zenger, M., & Brähler, E. (2014). The quality of life questionnaire EQ-5D-5L: Psychometric properties and normative values for the general German population. Quality of Life Research, 23(2), 443–447.CrossRefPubMedGoogle Scholar
  20. 20.
    Kim, T. H., Jo, M.-W., Lee, S.-I., Kim, S. H., & Chung, S. M. (2013). Psychometric properties of the EQ-5D-5L in the general population of South Korea. Quality of Life Research, 22(8), 2245–2253.CrossRefPubMedGoogle Scholar
  21. 21.
    Badia, X., Fernandez, E., & Segura, A. (1995). Influence of socio-demographic and health status variables on evaluation of health states in a Spanish population. The European Journal of Public Health, 5(2), 87–93.CrossRefGoogle Scholar
  22. 22.
    Dolan, P. (1996). The effect of experience of illness on health state valuations. Journal of Clinical Epidemiology, 49(5), 551–564.CrossRefPubMedGoogle Scholar
  23. 23.
    Badia, X., Herdman, M., & Kind, P. (1998). The influence of ill-health experience on the valuation of health. Pharmacoeconomics, 13(6), 687–696.CrossRefPubMedGoogle Scholar
  24. 24.
    Lamers, L. M., McDonnell, J., Stalmeier, P. F., Krabbe, P. F., & Busschbach, J. J. (2006). The Dutch tariff: Results and arguments for an effective design for national EQ-5D valuation studies. Health Economics, 15(10), 1121–1132.CrossRefPubMedGoogle Scholar
  25. 25.
    Badia, X., Roset, M., Herdman, M., & Kind, P. (2001). A comparison of United Kingdom and Spanish general population time trade-off values for EQ-5D health states. Medical Decision Making, 21(1), 7–16.CrossRefPubMedGoogle Scholar
  26. 26.
    Spanish National Statistics Institute. National Health Survey 2011–2012. Accessed July 15, 2014.
  27. 27.
    EuroQol., EQ-5D-5L., sets. v. Accessed July 1, 2012.
  28. 28.
    Dolan, P., Gudex, C., Kind, P., & Williams, A. (1996). The time trade-off method: Results from a general population study. Health Economics, 5(2), 141–154.CrossRefPubMedGoogle Scholar
  29. 29.
    Kularatna, S., Whitty, J. A., Johnson, N. W., Jayasinghe, R., & Scuffham, P. A. (2014). EQ-5D-3L derived population norms for health related quality of life in Sri Lanka, PLoS One, 9(11), e108434.Google Scholar
  30. 30.
    Abdin, E., Subramaniam, M., Vaingankar, J. A., Luo, N., & Chong, S. A. (2014) Population norms for the EQ-5D index scores using Singapore preference weights. Quality of Life Research, 24(6), 1545–53.CrossRefPubMedGoogle Scholar
  31. 31.
    Kind, P., Dolan, P., Gudex, C., & Williams, A. (1998). Variations in population health status: Results from a United Kingdom national questionnaire survey. BMJ, 316(7133), 736–741.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Ferreira, L. N., Ferreira, P. L., Pereira, L. N., & Oppe, M. (2014). EQ-5D Portuguese population norms. Quality of Life Research, 23(2), 425–430.CrossRefPubMedGoogle Scholar
  33. 33.
    Hinz, A., Kohlmann, T., Stobel-Richter, Y., Zenger, M., & Brahler, E. (2014). The quality of life questionnaire EQ-5D-5L: Psychometric properties and normative values for the general German population. Quality of Life Research, 23(2), 443–447.CrossRefPubMedGoogle Scholar
  34. 34.
    Mackenbach, J. P., & Kunst, A. E. (1997). Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe. Social Science and Medicine, 44(6), 757–771.CrossRefPubMedGoogle Scholar
  35. 35.
    Wagstaff, A., Paci, P., & van Doorslaer, E. (1991). On the measurement of inequalities in health. Social Science and Medicine, 33(5), 545–557.CrossRefPubMedGoogle Scholar
  36. 36.
    Badia, X., Schiaffino, A., Alonso, J., & Herdman, M. (1998). Using the EuroQol 5-D in the Catalan general population: Feasibility and construct validity. Quality of Life Research, 7(4), 311–322.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • M. A. Garcia-Gordillo
    • 1
    • 2
  • J. C. Adsuar
    • 3
  • P. R. Olivares
    • 4
  1. 1.Department of Applied Economics, Faculty of Economics and BusinessUniversity of MurciaMurciaSpain
  2. 2.Department of Economics, Faculty of Economics and BusinessUniversity of ExtremaduraBadajozSpain
  3. 3.Faculty of Sport SciencesUniversity of ExtremaduraCáceresSpain
  4. 4.Universidad Autonoma de ChileTalcaChile

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