How do Zimbabweans value health states?

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dc.contributor.authorJelsma, Jenniferen_ZA
dc.contributor.authorHansen, Kristianen_ZA
dc.contributor.authorde Weerdt, Willyen_ZA
dc.contributor.authorde Cock, Paulen_ZA
dc.contributor.authorKind, Paulen_ZA
dc.date.accessioned2015-10-12T10:56:47Z
dc.date.available2015-10-12T10:56:47Z
dc.date.issued2003en_ZA
dc.description.abstractBACKGROUND:Quality of life weights based on valuations of health states are often used in cost utility analysis and population health measures. This paper reports on an attempt to develop quality of life weights within the Zimbabwe context. METHODS: 2,384 residents in randomly selected small residential plots of land in a high-density suburb of Harare valued descriptors of 38 health states based on different combinations of the five domains of the EQ-5D (mobility, self-care, usual activities, pain or discomfort and anxiety or depression). The English version of the EQ-5D was used. The time trade-off method was used to determine the values, and 19,020 individual preferences for health states were analysed. A residual maximum likelihood linear mixed model was used to estimate a function for predicting the values of all possible combinations of levels on the five domains. The model was fit to a random subset of two-thirds of the observations, with the remaining observations reserved for analysis of predictive validity. The results were compared to a similar study undertaken in the United Kingdom. RESULTS: A credible model was developed to predict the values of states that were not valued directly. In the subset of observations reserved for validation, the mean absolute difference between predicted and observed values was 0.045. All domains of the EQ-5D were found to contribute significantly to the model, both at the moderate and severe levels. Severe pain was found to have the largest negative coefficient, followed by the inability to wash and dress oneself. CONCLUSION: Despite a generally lower education level than their European counterparts, urban Zimbabweans appear to value health states in a consistent manner, and the determination of a global method of establishing quality of life weights may be feasible and valid. However, as the relative weightings of the different domains, although correlated, differed from the standard set of weights recommended by the EuroQol Group, the locally determined coefficients should be used within the Zimbabwean context.en_ZA
dc.identifier.apacitationJelsma, J., Hansen, K., de Weerdt, W., de Cock, P., & Kind, P. (2003). How do Zimbabweans value health states?. <i>Population Health Metrics</i>, http://hdl.handle.net/11427/14187en_ZA
dc.identifier.chicagocitationJelsma, Jennifer, Kristian Hansen, Willy de Weerdt, Paul de Cock, and Paul Kind "How do Zimbabweans value health states?." <i>Population Health Metrics</i> (2003) http://hdl.handle.net/11427/14187en_ZA
dc.identifier.citationJelsma, J., Hansen, K., De Weerdt, W., De Cock, P., & Kind, P. (2003). How do Zimbabweans value health states. Popul Health Metr, 1(11), 11-20.en_ZA
dc.identifier.ris TY - Journal Article AU - Jelsma, Jennifer AU - Hansen, Kristian AU - de Weerdt, Willy AU - de Cock, Paul AU - Kind, Paul AB - BACKGROUND:Quality of life weights based on valuations of health states are often used in cost utility analysis and population health measures. This paper reports on an attempt to develop quality of life weights within the Zimbabwe context. METHODS: 2,384 residents in randomly selected small residential plots of land in a high-density suburb of Harare valued descriptors of 38 health states based on different combinations of the five domains of the EQ-5D (mobility, self-care, usual activities, pain or discomfort and anxiety or depression). The English version of the EQ-5D was used. The time trade-off method was used to determine the values, and 19,020 individual preferences for health states were analysed. A residual maximum likelihood linear mixed model was used to estimate a function for predicting the values of all possible combinations of levels on the five domains. The model was fit to a random subset of two-thirds of the observations, with the remaining observations reserved for analysis of predictive validity. The results were compared to a similar study undertaken in the United Kingdom. RESULTS: A credible model was developed to predict the values of states that were not valued directly. In the subset of observations reserved for validation, the mean absolute difference between predicted and observed values was 0.045. All domains of the EQ-5D were found to contribute significantly to the model, both at the moderate and severe levels. Severe pain was found to have the largest negative coefficient, followed by the inability to wash and dress oneself. CONCLUSION: Despite a generally lower education level than their European counterparts, urban Zimbabweans appear to value health states in a consistent manner, and the determination of a global method of establishing quality of life weights may be feasible and valid. However, as the relative weightings of the different domains, although correlated, differed from the standard set of weights recommended by the EuroQol Group, the locally determined coefficients should be used within the Zimbabwean context. DA - 2003 DB - OpenUCT DO - 10.1186/1478-7954-1-11 DP - University of Cape Town J1 - Population Health Metrics LK - https://open.uct.ac.za PB - University of Cape Town PY - 2003 T1 - How do Zimbabweans value health states? TI - How do Zimbabweans value health states? UR - http://hdl.handle.net/11427/14187 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14187
dc.identifier.urihttp://dx.doi.org/10.1186/1478-7954-1-11
dc.identifier.vancouvercitationJelsma J, Hansen K, de Weerdt W, de Cock P, Kind P. How do Zimbabweans value health states?. Population Health Metrics. 2003; http://hdl.handle.net/11427/14187.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDivision of Physiotherapyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourcePopulation Health Metricsen_ZA
dc.source.urihttp://www.pophealthmetrics.com/en_ZA
dc.subject.otherPopulation Health Measurementen_ZA
dc.titleHow do Zimbabweans value health states?en_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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