Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Estimating Quality Adjusted Life Year Loss of Persons Disabled by Stroke Using EQ-5D in Korea

EQ-5D를 이용한 뇌졸중 장애인의 질보정수명 감소분 추정

  • Jo, Min-Woo (Dept. of Preventive Medicine, College of Medicine, University of Ulsan) ;
  • Kim, Sang-Kyu (Dept. of Preventive Medicine, College of Medicine, Dongguk University) ;
  • Lee, Jin-Yong (Dept. of Preventive Medicine, College of Medicine, Konyang University) ;
  • Lee, Kyeong-Soo (Dept. of Preventive Medicine and Public Health, College of Medicine, Yeungnam University)
  • 조민우 (울산대학교 의과대학 예방의학교실) ;
  • 김상규 (동국대학교 의과대학 예방의학교실) ;
  • 이진용 (건양대학교 의과대학 예방의학교실) ;
  • 이경수 (영남대학교 의과대학 예방의학교실)
  • Received : 2011.06.02
  • Accepted : 2011.06.24
  • Published : 2011.06.30
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Abstract

The purposes of this study were to measure health related quality of life (HRQOL) of persons disabled by stroke dwelling in Gyeongju-si using EQ-5D and to estimate total QALYs loss of persons disabled by stroke in Korea. The eligible subjects were 982 persons with stroke aged 50 and over in Gyeongju-si disabled registry, as of March, 2008. Interviewers measured HRQOL of study subjects using EQ-5D. EQ-5D index, utility weight, was derived from the Korean valuation set. In order to compare the results of this study, we selected two comparison groups representing Korean healthy population and general population of Korean using the 4th Korean National Health & Nutrition Examination Survey. Finally, after age and gender standardization, we estimated the total QALYs losses of persons disabled by stroke in Korea. Of 982 eligible subjects, 566 persons participated in the survey (response rate: 57.6%). In both of female and male, utility weights in the 70s or 80s were lower than those of the 50s or 60s. Utility weights differences among persons with disability, general population, and healthy population in male were larger than those differences in female. Total estimated QALY losses of persons disabled by stroke were 67,011.6 QALYs lower than healthy control group and 54,167.1 QALYs lower than general population, respectively.

목적: 뇌졸중으로 인한 장애인이 증가하고 있으나 이들을 대상으로 질보정수명을 구한 연구가 없었다. 이 연구의 목적은 일개 시에서 뇌졸중 장애인을 대상으로 EQ-5D로 그들의 건강 관련 삶의 질 수준을 평가하고, 우리나라 전체 뇌졸중 장애인의 QALYs 감소분을 추정하기 위하여 수행 하였다. 방법: 2008년 3월을 기준으로 경주시 장애인 등록현황에서 50세 이상인 장애인 중 뇌졸중이 원인으로 파악된 982명을 대상으로 설문조사자들이 방문하여 대면면접조사를 통해 일반적 특성, 임상적 특성, EQ-5D 등의 자료를 수집하였다. 제4기 국민건강영양조사 에서 일반인구집단과 동반질환이 없는 군을 건강비교군으로 선정하여 성별, 연령별 표준화를 통해 비교함으로써 효용 가중치 차이를 구하였다. 이 효용 가중치 차이를 우리나라 전체 뇌졸중 장애인에 적용하여 전체 QALYs 감소분을 추정하였다. 결과: 대상자 982명 중 조사응답자는 566명으로 응답률은 57.6%였다. 여성, 70대 이상군에서 EQ-5D 지표값이 남성이나 60대 이하군에 비해 더 낮았고, 상대 비교군과의 차이도 크게 나타났다. 건강비교군과 일반인구집단 비교군과의 비교에 따른 전체 QALYs 감소분은 각각 연간 67,011.6 QALYs와 54,167.1 QALYs로 추정되었다. 결론: EQ-5D로 우리나라 전체 뇌졸중장애인의 QALYs 감소분을 추정하였고, 이 연구를 바탕으로 뇌졸중 장애인을 대상으로 한 공중보건정책의 집행이나 평가를 수행하여 보다 근거에 기반한 장애인 정책을 수행할 수 있을 것으로 생각한다.

Keywords

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