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Trend in health-related quality of life and health utility and their decrements due to non-communicable diseases and risk factors: analysis of four population-based surveys between 1998 and 2015

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Abstract

Purpose

To revisit the population norms of health-related quality of life (HRQoL) and health utility for the Hong Kong general population, compare these scores over past health surveys, and assess the association of scores with non-communicable diseases (NCDs) and their risk factors.

Methods

HRQoL data measured by the standard Short Form 12 Health Survey-version 2 (SF-12v2) were extracted from the surveys in 1998, 2003/2004, 2008/2009 and 2014/2015. SF-12v2 data were mapped to the Short-form 6-dimension (SF-6D) preference-based measure to generate the health utility scores. Population weighting based on the sex and age in the second quarter of 2015 was applied when generating population normative values. Linear regression models were fitted to assess the effect of the number of NCDs and modifiable lifestyle factors on HRQoL and health utility.

Results

The general population mean scores of SF-12v2 domains and SF-6D in 2014/15 were higher compared to past surveys. Linear increases in General Health, Vitality and Mental Health domains were observed from 1998 to 2014/15. More doctor-diagnosed NCDs, insufficient physical activity and fruit/vegetable consumption, poor sleep quality and insufficient or excessive amount of sleep (< 6/≥ 10 h) were all associated with worse physical- and mental-related HRQoL and health utility.

Conclusion

This study compared HRQoL and health utility in the Hong Kong general population derived from multiple surveys and found an improving trend over twenty years. More NCDs were associated with worse HRQoL. It is suggested that promoting adequate physical activity, consumption of fruit/vegetable and 6–9 h of sleep could improve health.

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Fig. 1

*SF-6D health utility were mapped from the responses of SF-12v2 health survey. Shaded region represents the corresponding 95% confidence interval SF-12v2 results in 2003/04 was converted from SF-12 – version 1 health survey

Fig. 2

The 95% confidence interval of scores is presented in black coloured font. †Population weighting allocated by age group and gender of survey respondents was applied to sample level to estimate the results with respect to the land-based non-institutional population of Hong Kong in the second quarter of 2015. ‡SF-6D health utility were mapped from the responses of SF-12v2 health survey. §Healthy population refers to respondents who did not report any non-communicable diseases

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Acknowledgements

The authors wish to acknowledge the Department of Health (DH) of the Government of the Hong Kong Special Administrative Region for the provision of study data.

Funding

No funding was received for this work.

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Authors and Affiliations

  1. Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1-01, 1/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China

    Eric Ho Man Tang, Carlos King Ho Wong, Laura Elizabeth Bedford, Esther Yee Tak Yu, Emily Tsui Yee Tse, Weinan Dong, Tingting Wu & Cindy Lo Kuen Lam

  2. Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China

    Bernard Man Yung Cheung

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  1. Eric Ho Man Tang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by EHMT, CKHW, LEB, EYTY, ETYT, WD, BMYC and CLKL. The first draft of the manuscript was written by EHMT, CKHW and LEB. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Carlos King Ho Wong.

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Conflict of interest

No financial relationships with any organizations that might have an interest in the submitted work. No other relationships or activities that could appear to have influenced the submitted work. CKHW reports receipt of research funding from the EuroQoL Group Research Foundation, the Hong Kong Research Grants Council, and the Hong Kong Health and Medical Research Fund. CLKL reports receipt of research funding from the Hong Kong Research Grants Council, the Hong Kong Health and Medical Research Fund, and the Kerry Group and Kouk Foundation Endowed Primary Care Research Fund of the University of Hong Kong. No other disclosures were reported.

Ethics approval

Ethics approval was not required from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West due to the secondary analysis of open source de-identified government data.

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

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Tang, E.H.M., Wong, C.K.H., Bedford, L.E. et al. Trend in health-related quality of life and health utility and their decrements due to non-communicable diseases and risk factors: analysis of four population-based surveys between 1998 and 2015. Qual Life Res 29, 2921–2934 (2020). https://doi.org/10.1007/s11136-020-02560-z

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