Double trouble: the impact of multimorbidity and deprivation on preference-weighted health related quality of life - a cross sectional analysis of the Scottish Health Survey

Lawson, K., Mercer, S., Wyke, S., Grieve, E., Guthrie, B., Watt, G.C.M. and Fenwick, E. (2013) Double trouble: the impact of multimorbidity and deprivation on preference-weighted health related quality of life - a cross sectional analysis of the Scottish Health Survey. International Journal for Equity in Health, 12(67), (doi:10.1186/1475-9276-12-67)

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Abstract

Objective To investigate the association between multimorbidity and Preference_Weighted Health Related Quality of Life (PW_HRQoL), a score that combines physical and mental functioning, and how this varies by socioeconomic deprivation and age.

Design The Scottish Health Survey (SHeS) is a cross-sectional representative survey of the general population which included the SF-12, a survey of HRQoL, for individuals 20 years and over.

Methods For 7,054 participants we generated PW_HRQoL scores by running SF-12 responses through the SF-6D algorithm. The resulting scores ranged from 0.29 (worst health) to 1 (perfect health). Using ordinary least squares, we first investigated associations between scores and increasing counts of longstanding conditions, and then repeated for multimorbidity (2+ conditions). Estimates were made for the general population and quintiles of socioeconomic deprivation. For multimorbidity, the analyses were repeated stratifying the population by age group (20--44, 45--64, 65+).

Results 45% of participants reported a longstanding condition and 18% reported multimorbidity. The presence of 1, 2, or 3+ longstanding conditions were associated with average reductions in PW_HRQoL scores of 0.081, 0.151 and 0.212 respectively. Reduction in scores associated with multimorbidity was 33% greater in the most deprived quintile compared to the least deprived quintile, with the biggest difference (80%) in the 20--44 age groups. There were no significant gender differences.

Conclusions PW_HRQoL decreases markedly with multimorbidity, and is exacerbated by higher deprivation and younger age. There is a need to prioritise interventions to improve the HRQoL for (especially younger) adults with multimorbidity in deprived areas.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wyke, Professor Sally and Grieve, Miss Eleanor and Mercer, Professor Stewart and Watt, Professor Graham and Fenwick, Professor Elisabeth
Authors: Lawson, K., Mercer, S., Wyke, S., Grieve, E., Guthrie, B., Watt, G.C.M., and Fenwick, E.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
College of Social Sciences
Journal Name:International Journal for Equity in Health
Publisher:BioMed Central
ISSN:1475-9276
ISSN (Online):1475-9276
Copyright Holders:Copyright © 2013 The Authors
First Published:First published in International Journal for Equity in Health 12(67)
Publisher Policy:Reproduced under a Creative Commons License

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