比較健康效用權數，付費意願與生活品質量表之相關性 -以乾癬患者為例

Health-State Utilities, Willingness to Pay and their Association with Health-Related Quality of Life among Patients with Psoriasis in Taiwan

張景雯(Ching-Wen Chang)

指導教授 ： 湯澡薰

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2010年)

https://doi.org/10.6831/TMU.2010.00168

摘要

目的: 乾癬是一種慢性且不具傳染性的皮膚病。許多研究指出，該疾病對病人的生活品質有相當大的衝擊，目前有許多乾癬藥物臨床試驗成效，除了以客觀的嚴重度指標監測外，並將乾癬病人認知生活品質是否改善納入考量，可見生活品質是一個重要的指標，然而目前測量生活品質的指標眾多，如何選擇適合乾癬患者使用的測量工具是一重要課題。本研究目的為，1) 以皮膚學生活品質量表(Dermatology Life Quality Index, DLQI)為基準，探討健康效用權數、付費意願與是否能有效表達健康相關生活品質。2)以皮膚學生活品質量表(Dermatology Life Quality Index, DLQI)為基準，探討不同疾病嚴重度PASI之下，健康效用權數、付費意願是否能有效表達健康相關生活品質。3)以皮膚學生活品質量表(Dermatology Life Quality Index, DLQI)為基準，探討疾病嚴重度PASI是否有效表達健康相關生活品質。
方法:本研究採面對面訪談進行問卷填寫，收案地點為北、中、南四家皮膚科門診，調查期間為 2009年8月至2010年5月，樣本數為480 人。健康效用權數的衡量方面，包含視覺的類似語等級法(Visual analogue scale, VAS)、EQ-5D、時間交換法(Time trade 0ff)。付費意願採雙界二分法與開放式問答詢問。
結果:受訪者平均年齡為 44.5 歲，平均病史為 10.9 年，75%受訪者為男性。平均健康效用權數 0.87(EQ-5D)，0.72(VAS)，0.74(TTO)。輕中重病人每月願付的上限金額，分別為 4649 元、8372 元、10200 元。EQ-5D、VAS 與皮膚學生活品質(DLQI)構面呈現顯著負相關，付費意願與 DLQI 有高度相關且方向性一致。TTO 與 DLQI 構面有顯著相關，但相關強度低。
結論: EQ-5D、VAS、WTP 與 DLQI 構面間有高度相關性，適用於測量台灣乾癬病人的健康相關生活品質。

關鍵字: 健康效用權數、付費意願、健康相關生活品質量表

關鍵字

健康效用權數 ； 付費意願 ； 健康相關生活品質量表

並列摘要

Title of Thesis: Health-State Utilities, Willingness to Pay and their Association with Health-Related Quality of Life among Patients with Psoriasis in Taiwan
Author: Ching-Wen Chang
Thesis advised by: Chao-Hsiun Tang, Ph.D.

OBJECTIVES: Psoriasis has a major impact on patients’ quality of life, as commonly measured by the Dermatology Life Quality Index (DLQI). Three Objectives of this study: 1) to examine how these different measures of utilities and WTP were related to DLQI. 2) to examine how these different measures of utilities and WTP were related to DLQI by disease severity. 3) to exaim the relationship between disease severity and DLQI, health-related utilities,and willingness-to-pay (WTP) for patients with psoriasis,
METHODS: Face-to-face patient interviews were carried out with 364 patients with psoriasis during August 2009 and February 2010 at dermatology outpatient clinics in five hospitals located in northern, central and southern Taiwan. Utilities were elicited using time trade-off (TTO), visual analogue scale (VAS) and EQ-5D. The EQ-5D was scored based on the standard scoring formula. The WTP for a cure of psoriasis was elicited by double bounded binary-choice questions followed by a bidding game question.
RESULTS: Mean age was 44.5 years, mean history of disease was 10.9 years, and 75% of patients were male. The mean health utility was 0.87 (EQ-5D), 0.72 (VAS) and 0.74 (TTO). The WTP per month was between NT$4649 and NT$10200. Scores of EQ-5D and VAS were significantly negatively correlated to all of the dimensions of DLQI. The correlation of the dichotomous WTP with DLQI was also strong and in the expected direction. TTO was also significantly correlated with DLQI, but the relation was the weakest.
CONCLUSIONS: EQ-5D, VAS and WTP are consistent measures with DLQI in assessing the well-being of patients with psoriasis in Taiwan.

Key word: Health-State Utilities, Willingness to Pay, Health-Related Quality of Life

並列關鍵字

Health-State Utilities ； Willingness to Pay ； Health-Related Quality of Life

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