Subjective Health Status and Health Values in the General Population

Abstract

Objective. To explore the relationship between rating-scale evaluation of health-related quality of life ("health value") and two subjective evaluations of health: the SF-36 profile and the five-category perception of general health (excellent, very good, good, fair, and poor). Methods. This relationship was explored by linear and nonlinear regression analysis of data obtained through face-to-face interviews with a sample of 2,030 per sons aged 45-75 years representing the Israeli Jewish urban population in that age group. Results. The main outcome is a mapping assigning health values to the sub jective health-status scores, e.g., "good" general health is equivalent to a health value of 76-81, depending on the functional form of the relation. "Poor" health is equivalent to a value of 45-61. The R² is about 0.3. While the eight scales of the SF-36 were found to be linearly related to health value (R² = 0.51), the two summary measures— physical component scale (PCS) and mental component scale (MCS)—were not. The scales measuring general health, vitality, and physical functioning were the main de terminants of health value, while the role-performance scales were insignificant. The PCS had a larger effect than the MCS. Discussion. These relationships provide deeper insight into the structure and meaning of the two health-status measures in the general population. They also place earlier determinations of these relationships among sick persons in a broader context and raise several further questions regarding the rela tionship between health values and health status. Key words: rating scale; health- related quality of life; health value; MOS SF-36; subjective evaluation of health; Box- Cox regression. (Med Decis Making 1999;19:122-127)

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