Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health Status Indexes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Does literacy mediate the relationship between education and health outcomes? A study of a low-income population with diabetes.

OBJECTIVES: We sought to determine whether literacy mediates the relationship between education and glycemic control among diabetes patients. METHODS: We measured educational attainment, literacy using the Short Test of Functional Health Literacy in Adults (s-TOFHLA), and glycemic control (HbA1c) in 395 diabetes patients at a U.S. public hospital. We performed path analysis to compare two competing models to explain glycemic control. The direct effects model estimated how education was related to HbA1c; the mediational model estimated the strength of the direct relationship when the additional pathway from education to literacy to HbA1c was added. RESULTS: Both the model with a direct effect of education on HbA1c and the model with literacy as a mediator were supported by good fit to observed data. The mediational model, however, was a significant improvement, with the additional path from literacy to HbA1c reducing the discrepancy from observed data (p < 0.01). After including this path, the direct relationship between education and HbA1c fell to a non-significant threshold. CONCLUSIONS: In a low-income population with diabetes, literacy mediated the relationship between education and glycemic control. This finding has important implications for both education and health policy.

Diabetes Mellitus↗
PubMed2001

Measuring health status using the Health Utilities Index: agreement between raters and between modalities of administration.

The aim of this study was to evaluate interrater and intermodality agreement in assessing health status using the Health Utilities Index. A random sample from a Dutch cohort of 14-year-old Very Low Birth Weight children and their parents were invited to participate in a face-to-face (n = 150) or telephone (n = 150) interview. All 300 participants were also sent a questionnaire by mail. Response rate was 68%. Interrater and intermodality agreement were high for the physical HUI3 attributes and poor for the psychological attributes. Children and parents reported more dysfunction in the psychological attributes when interviewed than when completing the mailed questionnaire. High agreement on the physical attributes may have resulted from the fact that hardly any dysfunction was reported in these attributes, and poor agreement in the psychological attributes may have been a result of the fact that in these attributes much more dysfunction was reported. In measuring children's health status using the HUI3, the results and their interpretation vary with the source of information and the modality of administration. For maximum comparability between studies, written self-report questionnaires seem the preferred option.

Adolescent↗
PubMed1997

Evaluation of index and profile measures of health status in a randomized controlled trial. Comparison of the Medical Outcomes Study 36-Item Short Form Health Survey, EuroQol, and disease specific measures.

OBJECTIVES: The authors compare two generic measures of health status with disease-specific measures in a randomized controlled trial of transurethral resection of the prostate with laser vaporization prostatectomy for benign prostatic hypertrophy. METHODS: Patients entered into the trial completed the following questionnaires prior to treatment and at follow-up at 3 months and 1 year. The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) is a generic measure that produces an eight-dimension profile as well as two summary measures of health status (the physical component score and the mental component score). The EuroQol provides two single index measures of health status; one intended to convey the utility (or lack of) that an individual derives from his or her own health state compared with alternative states and a second simple visual analog scale "thermometer" of health status. The American Urological Association symptom score and the Bothersome index are disease-specific indices of health status for use specifically with benign prostatic hypertrophy patients. RESULTS: The EuroQol indicates no statistically significant improvements with time for either arm of the trial. The SF-36 physical and general health perceptions domains indicates statistically significant improvements for the transurethral resection of the prostate arm alone at 3 months and 1 year, as do the physical summary score at the 3-month follow-up visit. The effect sizes of these improvements, however, are small, using standard criteria. In contrast, statistically significant differences are found with time for both transurethral resection of the prostate and laser prostatectomy on both disease-specific measures, which also indicate statistically significant superior outcome for the transurethral resection of the prostate arm compared with the laser arm. CONCLUSIONS: The results indicate that the disease-specific measures are more sensitive to change than the generic measures of outcome. Possible explanations for this are discussed.

Follow-Up Studies↗
PubMed1995

A comprehensive index for longitudinal monitoring of child health status.

The aim of this study was to develop a single comprehensive index of child mortality for longitudinal assessment of health status of children. The need for such a comprehensive index arose from conflicting trends in different child mortality indicators. The data for the study was taken from the Sample Registration System (SRS) reports of the Registrar General of India. SRS is known to provide reliable estimates of births and deaths at the State and the National level. The study included five child mortality indicators, namely, under five mortality rate (U5MR), infant mortality rate, neonatal mortality rate, perinatal mortality rate and still birth rate. These were available for fifteen states of India over the years 1972-1988. To develop this index we modified an earlier method based on factor analysis. Factor analysis of data on various indicators of child mortality revealed two factors which together explained 78% to 93% of the total variation in different years. The first factor was identified as representing mortality after birth and the second as before and during birth. The comprehensive index was obtained as a linear combination of these two factors. The resultant index thus fairly represented all five mortality indicators and provided a comprehensive and reasonably correct picture of child mortality. The lower the magnitude of this index, the better was the child health status. Trends in the index showed that the highest decline in the magnitude was in the state of Kerala followed by Punjab, Andhra Pradesh, Gujarat and Maharashtra in that order. This indicates steady improvement of the child health status over years in these states. In the State of Jammu and Kashmir, the index remained more or less constant over the years though the magnitude was low in the cross-sectional comparison with other states. Thus the comprehensive index developed by using factor analysis of the various mortality indicators can be used for the longitudinal monitoring of child health status in the states of India.

Child↗
PubMed1995

Multi-attribute health status classification systems. Health Utilities Index.

In this article, multi-attribute approaches to the assessment of health status are reviewed with a special focus on 2 recently developed systems, the Health Utilities Index (HUI) Mark II and Mark III systems. The Mark II system consists of 7 attributes: sensation, mobility, emotion, cognition, self-care, pain and fertility. The Mark III system contains 8 attributes: vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain. Each attribute consists of multiple levels of functioning. A combination of levels across the attributes constitutes a health state. The HUI systems are deliberately focused on the fundamental core attributes of health status, and on the capacity of individuals to function with respect to these attributes. Thus, the measure obtained constitutes a pure description of health status, uncontaminated by differential opportunity or preference. Multi-attribute systems provide a compact but comprehensive framework for describing health status for use in population health and programme evaluation studies. An important advantage of such systems is their ability to simultaneously provide detail on an attribute-by-attribute basis and to capture combinations of deficits among attributes. An additional advantage is their compatibility with multi-attribute preference functions, which provide a method for computing a summary health-related quality-of-life score for each health state.

Canada↗
PubMed1995

The Health Utility Index: measuring health differences in Ontario by socioeconomic status.

The positive relationship between socioeconomic status (SES) and longevity has long been established. Comparable evidence exists for SES and morbidity, but observations of this relationship tend to be limited to specific health indicators. In this article, a comprehensive quantitative measure of health status, the Health Utility Index (HUI), is applied to an analysis of the relationship between SES and the health status of people aged 25 and over in Ontario. The HUI, based on a set of questions included in the 1990 Ontario Health Survey (OHS), provides a summary index of the health of each respondent. The OHS data show that lower levels of education, income, and occupation are associated with lower HUI values. Health status differences across SES groups are greater in late middle-age than at younger or older ages, a pattern consistent with the findings of other studies. The development of summary indicators like the HUI is part of a larger effort to construct measures for monitoring the health of Canadians.

Adult↗
PubMed2006

The association between cumulative periodontal disease and stroke history in older adults.

BACKGROUND: Since the late 1980s, several studies have been conducted to investigate the relationship between periodontal disease and ischemic stroke. The purpose of this study is to investigate the relationship of periodontal disease to the self-reported history of stroke in the elderly (60 years of age and older) by examining the data of the Third National Health and Nutrition Examination Survey (NHANES III). METHODS: Data from NHANES III, a large population-based cross-sectional survey of the United States, were used for this study. Because 1,563 of the 5,123 subjects in the study were edentulous, and periodontal disease is a major cause of tooth loss, it was necessary to account for edentulousness in the statistical analysis to avoid bias. Hence, a new index called the periodontal health status (PHS) index was developed to address this problem. Two measures of PHS were developed: PHS I, based on the median percentage of sites with >/=2 mm clinical attachment loss (CAL), and PHS II, based on the median percentage of sites with >/=3 mm CAL. Multiple logistic regression analysis was used to test for the association of PHS with stroke history. Two types of a multiple logistic regression model were fit: 1) logistic regression modeling with adjustment for age and tobacco use only; and 2) logistic regression modeling with adjustment of all statistically significant confounders. RESULTS: Based on multiple logistic regression analysis of PHS with adjustment for age and tobacco use only, completely edentulous elderly adults (PHS Class 5) and partially edentulous (teeth in one arch) elderly adults with appreciable clinical attachment loss (PHS Class 4) were significantly more likely to have a history of stroke compared to dentate adults (teeth in both arches) without appreciable clinical attachment loss (PHS Class 1). When multiple logistic regression models were fit with adjustment of all significant confounders, no statistically significant association was found between PHS and stroke. CONCLUSIONS: Based on the results of this study, there is evidence of an association between cumulative periodontal disease, based on PHS, and a history of stroke. However, it is unclear whether cumulative periodontal disease is an independent risk factor for stroke or a risk marker for the disease.

Age Factors↗
PubMed1996

Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2.

The Health Utilities Index Mark 2 (HUI:2) is a generic multiattribute, preference-based system for assessing health-related quality of life. Health Utilities Index Mark 2 consists of two components: a seven-attribute health status classification system and a scoring formula. The seven attributes are sensation, mobility, emotion, cognition, self-care, pain, and fertility. A random sample of general population parents were interviewed to determine cardinal preferences for the health states in the system. The health states were defined as lasting for a 60-year lifetime, starting at age 10. Values were measured using visual analogue scaling. Utilities were measured using a standard gamble technique. A scoring formula is provided, based on a multiplicative multiattribute utility function from the responses of 194 subjects. The utility scores are death-anchored (death = 0.0) and form an interval scale. Health Utilities Index Mark 2 and its utility scores can be useful to other researchers in a wide variety of settings who wish to document health status and assign preference scores.

Adolescent↗
PubMed2005

The association between medication usage and dropout status among participants of an exercise study for people with osteoarthritis.

BACKGROUND AND PURPOSE: Little is known about predictors of dropout status in exercise studies for people with osteoarthritis. Losses to follow-up can pose serious threats to study validity. The purpose of this study was to assess the ability of arthritis medication usage the month prior to enrollment to predict dropout status among participants in an exercise study for people with osteoarthritis. SUBJECTS AND METHODS: Men and women who participated in an exercise study for people with osteoarthritis (N=143) were followed. Participants who completed 24+ months of the exercise program were considered retained, whereas individuals who withdrew prior to 24 months were considered dropouts. RESULTS: Of the 143 participants analyzed, 78 (55%) completed 24+ months of the exercise program and 65 (45%) dropped out. Among those who reported arthritis medication usage, 54% were lost to follow-up. The group reporting no usage of arthritis medication had a 20% dropout rate (odds ratio=3.5, 95% confidence interval=1.6-7.6). The final adjusted model controlling for baseline health status, body mass index, and the interaction between baseline health status and body mass index indicated that those individuals who reported arthritis medication usage were more than 4 times more likely to drop out than were those who reported no arthritis medication usage (odds ratio=4.5, 95% confidence interval=1.8-11.4). DISCUSSION AND CONCLUSION: The results showed that self-reported arthritis medication usage the month prior to study enrollment was associated with subsequent dropout status among this group of exercisers with osteoarthritis. Further identification of baseline characteristics predictive of participant dropout status may benefit future exercise studies. A priori knowledge of "at-risk" exercise study participants will afford the opportunity for the timely allocation of appropriate resources aimed at reducing losses to follow-up.

Aged↗
PubMed1992

Benefits and obstacles for development of health status assessment measures in clinical settings.

Health status measures offer scientific, humanistic, and economic benefits for clinical medicine. The main problem is the many intellectual and pragmatic obstacles that block successful development of these measures. The inventory of such problems includes the following: definition of health; medical components of health status; who makes the choice about what to include and emphasize; attributes to be rated by patients or clinicians; indexes to be created from those attributes (including mega-variable indexes, global indexes, and oligo-category indexes); different measurements of the same entity; and clinimetric problems in nonclinimetric models. Several solutions to these multiple, complex difficulties can be offered: 1) ensure that a specific purpose, focus, and setting are clearly identified for every health status index; 2) recognize that an off-the-shelf index with high statistical scores for so-called reliability and validity may not be pertinent for a given current situation in which it is to be used; 3) avoid indexes involving combinations of excessive numbers of variables; 4) let patients choose the most significant foci and components of the indexes; 5) seek greater communication and understanding among multidisciplinary collaborators, who may have many differences in the ethos and goals with which they approach the construction of health status indexes; and 6) recognize that the construction of suitable health status indexes is an outstanding challenge in basic scientific inquiry, and, in this spirit, support major alterations in the current ideology for conceptualization and funding of what is basic science in clinical medicine.

Health Services Accessibility↗
PubMed1993

Surveillance for equity in maternal care in Zimbabwe.

The great hope and promise of post-independence efforts to promote equitable health care in Zimbabwe started with three years of dramatic improvement. Commitment to correcting inequities which were as discriminatory as any country in the world produced rapid extension of health centre infrastructure and the improvement of district hospitals. The major constraint was the entrenched pattern of sophisticated, high-technology health care left by colonial administrators which continued to monopolize resources. In spite of the excellent beginning, development of services for the poor was thwarted by recession, prolonged drought and external military destabilization. The cutbacks in funding for health care have been particularly severe as a result of economic adjustment policies imposed by IMF. Political pressure moved the health system toward private entrepreneurship returning to earlier patterns of discrimination in favour of whites and urban residents. Efforts to promote high-risk monitoring have had little impact among the poor and those living in remote areas. Equity has become symbolic rather than real. The government of Zimbabwe maintains a continuing commitment to the original goals of equity through primary health care. International agencies also would like to find a way to help reallocate services. There seems to be recognition that little will be accomplished in improving health conditions unless services are provided to those in greatest need. Disparities in maternal care are especially severe and can be improved only by building infrastructure to provide antenatal and perinatal services.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗
PubMed1998

Socioeconomic status and health in women with systemic lupus erythematosus.

OBJECTIVE: Health outcomes of patients with chronic illnesses are commonly worse in people of lower socioeconomic status (SES). We investigated psychosocial factors that may mediate the relationship between SES and measures of morbidity in women with systemic lupus erythematosus (SLE). METHODS: We collected information on SES, psychosocial factors, and health status in a cross sectional survey of 100 women with SLE. SES was rated using the Hollingshead Two-Factor Index, a weighted average of years of formal education and occupational prestige (higher Hollingshead Index=lower SES). Health status measures included the Health Assessment Questionnaire Disability Index (HAQ), the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR), the Systemic Lupus Activity Measure (SLAM), and the SLE Disease Activity Index (SLEDAI). Potential mediators consisted of 18 environmental, medical care, social, psychological, and behavioral factors. RESULTS: Patients with higher Hollingshead Indexes (lower SES) had more functional disability as measured by the HAQ (r=0.22: p=0.03) and more cumulative organ damage as measured by the SLICC/ACR Damage Index (r = 0.19; p=0.06). SES was not related to either the SLAM or SLEDAI. Significant univariate associations were present between the Hollingshead Index and 10 potential mediating variables: household crowding, insurance status, organizational barriers to medical care, depression, health locus of control by powerful others, SLE knowledge, social support, marital status, body mass index, and regular alcohol use. However, in multiple linear regression analyses, only 3 of these variables modified the relationship between Hollingshead Index and the HAQ: more severe depression scores, higher body mass index, and more restricted access to medical care. More severe depression and greater locus of control by powerful others tended to mediate the relationship between low SES and greater organ damage. CONCLUSION: SES is related to morbidity in women with SLE. There are identifiable and potentially modifiable mediators of this relationship.

Adult↗