Health-related quality of life and health care resource utilization in COPD patients: A comparison of three instruments
Abstract
This study involved comparison of the generic SF-36 questionnaire with two COPD-specific questionnaires, St. George's Respiratory Questionnaire (SGRQ), and the Chronic Respiratory Disease Questionnaire (CRDQ), using health care resource data, and considering a managed care perspective. The major research questions addressed were: (1) How do the results from three commonly used generic and disease-specific health-related quality of life (HRQOL) instruments vary when administered to a sample of COPD patients? (2) Which of the three scales (generic/disease-specific) correlates most closely and best predicts overall health care resource utilization for the sample? (3) What is the effect of demographic factors on health care resource utilization after the effects of health status are controlled for? COPD patients from a local managed care organization were contacted and the three health-related quality of life questionnaires were administered via telephone at two time points with a three-month interval between the two. Health care utilization data for the three-month periods prior to each interview were obtained at both times from the HMO medical records database. The net response rate was 24.3 percent. The sample, in general, consisted of middle-income patients in the age range of 41 to 71 years, many having COPD for more than five years, and having a number of comorbidities. All three instruments provided similar results with respect to health status of the patient sample with negligible improvements in the second time interval. In general, the sample had poor physical health and somewhat better mental health status. All health care resource utilization costs had large standard deviations with mean total utilization costs decreasing in the second time interval as compared to the first. Among all three instruments, the SF-36 was the instrument that best predicted the highest proportion of variation in many of the health care utilization measures. The aggregate scores such as the summary scores of the SF-36, and the total score of the SGRQ did not perform as well as the complete instruments with respect to predicting health care utilization. Demographic factors, in general, did not have much of an impact on utilization after the effects of health status were controlled for.
Degree
Ph.D.
Advisors
Rupp, Purdue University.
Subject Area
Pharmaceuticals|Public health|Welfare
Off-Campus Purdue Users:
To access this dissertation, please log in to our
proxy server.