Health status of the German population:: Results of a representative survey using the EuroQol questionnaire

Purpose: The EuroQol questionnaire (EQ-5D) is an instrument for subjectively describing and valuing health states. The purpose of this study was to measure the health status of the German population using the EQ-5D and to analyse the influence of sociodemographic factors. Methods: As part of the European Study of the Epidemiology of Mental Disorders (ESEMeD) a representative sample of the non-institutionalised population aged 18 and above in Germany was surveyed by personal computer-based interviews in 2002/2003. Besides questions relating to the prevalence of psychiatric disorders and their risk factors, the health status of 3552 respondents was recorded using the EQ-5D. Frequency and factors of influence on problems in the EuroQol items mobility, self-care, usual activities, pain/discomfort, anxiety/depression as well as the valuation of health state on the visual analog scale (VAS) were analysed. Results: 36% of the respondents report problems in at least one of the EuroQol items; most frequent were problems in the dimension pain/discomfort (28%), followed by mobility (17%), everyday activities (10%), anxiety/depression (4%) and self-care (3%). The mean VAS score was 77.4. Except for anxiety/depression the frequency of problems increased significantly with age and decreased with income. Women reported significantly more problems than men with regard to pain/discomfort and self-care. Having received more than 9 years of school education and being employed was associated with significantly fewer problems in all dimensions of the EuroQol. Living with a partner was associated with significantly fewer problems in the dimensions of self-care, usual activities and anxiety/depression. Multivariate analyses confirmed the effect of age, school education and employment on the frequency of problems, whereas for living with a partner only effects on self-care and anxiety/depression, and for gender only effects on pain/discomfort were confirmed. Income had no effect on frequency of problems in multivariate analyses. Young age, more than 9 years of school education, employment and living with a partner had a significantly positive effect on VAS score in multivariate analyses, while gender and income had no effect. Conclusions: The EQ-5D is a simple health state classification system, that can be used to detect variations in the health status of a population. This study provides EQ-5D-norm values for the German population.