Evaluating Health Inequality in Five Caribbean Basin Countries Using EQ-5D-5L

Henry H. Bailey (), Mathieu F. Janssen (), Fareena M. Alladin (), Althea Foucade (), Rodrigo Varela (), Jhon A. Moreno (), Marjorie Wharton (), Philip Castillo () and Girjanauth Boodraj ()
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Henry H. Bailey: The University of the West Indies
Mathieu F. Janssen: Erasmus MC
Fareena M. Alladin: The University of the West Indies
Althea Foucade: The University of the West Indies
Rodrigo Varela: Universidad Icesi
Jhon A. Moreno: Universidad Icesi
Marjorie Wharton: The University of the West Indies
Philip Castillo: University of Belize
Girjanauth Boodraj: University of Technology, Jamaica

Applied Health Economics and Health Policy, 2022, vol. 20, issue 6, No 7, 857-866

Abstract: Abstract Background EQ-5D-5L is a standardized health outcomes instrument that can be added to national surveys to measure inequality in health outcomes. The aim of this study was to produce baseline values of health inequality using EQ-5D-5L for five countries in the Caribbean Basin region based on national surveys in 2012–2014. Methods The EQ-5D-5L questionnaire was included in adult population surveys of Barbados, Belize, Colombia, Jamaica and Trinidad and Tobago. EQ-5D-5L measures were calculated for demographic groups using stratifiers from the World Health Organization’s PROGRESS-Plus framework, and generalized linear models were used to test for association between EQ-5D-5L and the PROGRESS-Plus variables. Ordered logit models were used to obtain odds ratios for the effect of the PROGRESS-Plus variables on reporting problems on the EQ-5D-5L dimensions. The Kakwani index was calculated for each country. Results Data were obtained for representative samples in each country, giving a combined total of 11,284 respondents. Different patterns of inequality were observed among the five countries. The biggest drivers of inequality were age and gender, and the biggest EQ-5D factors were self-care in Belize and pain/discomfort in the other four countries. Conclusion This study demonstrated that the EQ-5D-5L instrument can easily be added to national surveys. Inequality measures from this study can be used as baseline values for comparisons with future similar surveys in these five countries to infer changes in health inequality as measured by EQ-5D outcomes. These can be used to track the performance of policy initiatives aimed at specific demographic groups.

Date: 2022
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DOI: 10.1007/s40258-022-00754-9

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