SELF-REPORTED HEALTH STATUS AMONG TYPE 2 DIABETIC PATIENTS: A COMMUNITY-BASED SURVEY IN CHINA

Purpose: To assess self-reported health status using the EQ-ED-3L and identify factors determining the status change among Chinese type 2 diabetic patients (T2DP).

Method: Clinical diagnosed T2DP were recruited from 66 community health centres in five Chinese cities using a multistage quota sampling method between December 2010 and October 2011. Demographics and socioeconomic status, diabetes duration, comorbidities, treatments (i.e. insulin and oral hypoglycemic medications), and health-related behaviours (i.e. smoking, drinking, eating habits, exercise, and glucose monitoring) were collected via face-to-face interview at baseline. The EQ-5D-3L was administered at baseline and at 12-months. The China EQ-5D-3L value set was used to calculate utilities.

   According to their baseline responses to the EQ-5D-3L, all patients were categorized into two subgroups, those reported impaired health states (impaired-HS group) and those reported “11111” (“11111” group). For the impaired-HS group, least squares linear regression was used with the change in utilities as the dependent variable. For the “11111” group, the logistic regression with a dependent variable dichotomizing the utility change (i.e. no change vs worsening) was performed. Explanatory variables included age, gender, education, employment, health insurance, per capita household income, diabetes duration, comorbidities, treatments, health-related behaviour, and baseline utility.

Result: Totally 1,958 patients completed both baseline and the year-end interviews with 54.9% female, 75.9% ≥high school education, and 67.7% with comorbidities. The mean (standard deviation, SD) age years and diabetes duration were 61.2 (11.3) and 7.9 (6.3) years, respectively. The baseline utility, mean utility change, and mean absolute change were 0.896 (0.13), 0.02 (0.15), and 0.096 (0.11), respectively. Out of 989 “11111” group patients, 283 (28.6%) had a decreased utility (mean (SD), -0.187 (0.115)) at the year-end. Out of 969 impaired-HS group patients, 676 (69.8%) had an increased utility with the mean change of 0.166 (0.092), and 169 (17.4%) had a decreased utility (mean (SD), -0.128(0.102)). For the impaired-HS group, age, education, exercise, health insurance, and baseline utility were significant predictors for the change. No variable was found statistically significant for the “11111” group.

Conclusion: We observed substantial change in health utilities over a one-year time horizon among the ChineseT2DP who were managed at community health centres. Age, education, exercise, health insurance and baseline utility were the significant factors predicting the change among those who reported suboptimal health status at baseline.