Racial and Ethnic Differences in EQ5D Index Scores

Presenter: Michael Nichol, USC

Abstract

Aims: There is conflicting evidence as to whether racial and ethnic differences in health valuation exist. The objective of this study was to examine differences in EuroQol-5D (EQ5D) index scores between non-Hispanics (NH), Other Hispanics (OH), and Mexican/Mexican Americans (MA).
Methods: Using 2002 data from the nationally representative Medical Expenditure Panel Survey (MEPS), we computed mean EQ5D index scores for adult patients (>18) stratified to 3 cohorts (NH, OH, MA). Mean scores were compared across cohorts for the total sample and by the following 8 quality priority conditions (QPC): asthma, high blood pressure (Have you ever been told you have high blood pressure?), diagnosis of high blood pressure (Have you ever been diagnosed as having high blood pressure by a doctor?), heart disease, stroke, emphysema, joint pain, and arthritis. These QPC were selected by the Agency for Research on Healthcare Quality for inclusion in MEPS because they are prevalent conditions and standards for appropriate clinical care have been developed.
Results: EQ5D index scores for 18761 Non-Hispanics, 1442 Other Hispanics, and 3677 Mexican/Mexican Americans were compared. For the total sample, NH and OH had equivalent mean EQ5D scores (0.87), while the MA group scored significantly higher (0.89; F=18.74, p=0.0000). Across all QPC, however, OH had consistently lower mean scores as compared to NH and MA. MA had higher mean scores for asthma (0.84 vs. 0.82) and emphysema (0.79 vs. 0.68), while NH had higher mean scores for stroke (0.70 vs. 0.66) and arthritis (0.76 vs. 0.72). Significant mean differences across cohorts were found for the following conditions: high blood pressure (p=0.02), diagnosis of high blood pressure (p=0.02), heart disease (p=0.05), joint pain (p=0.0006), and arthritis (p=0.0001).
Conclusion: Valuation of health states appears to be lower for individuals of Other Hispanic origin afflicted with chronic conditions, as compared to Non-Hispanics and Mexican/Mexican Americans. Further research on Hispanic subgroups is essential to determine the factors associated with health valuation in efforts to eliminate disparities and encourage equitable health outcomes across racial/ethnic categories.