Health related quality of life and satisfaction with life in Croatia

1
Health related quality of life and satisfaction
with life in Croatia

• Gorka Vuletic, BPsychol, PhD
• Andrija Stampar School of Public HealthMedical
  Faculty, University of ZagrebCroatia

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Republic of Croatia

• One of 6 former Yugoslavian republics
• Estimated Croatian population cca. 4,500,000
• Capital city Zagreb 800,000

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How did Croatia become involved in QoL research?

• Deakin Uni 2001-2002 (PhD research)
• basis for further research in Croatia
• ?
• The 2003 Croatian National Health survey
• ?
• Through the survey we obtained
• Population normative data for
• Subjective quality of life (satisfaction with
  life)
• Health status (SF-36)

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ProjectCroatian National Health Survey 2003

• Founded by World Bank
• Co-operators
• Republic of Croatia Ministry of Health
• Canadian Society for International Health
• Project team was formed from
• Andrija Stampar School of Public Health
• National Institute for Public Health

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Sample

• 10,766 households were selected to participate in
  the survey (based on Census 2001).
• Out of these selected households a response was
  obtained from 9,070 individuals (overall response
  rate 84.3).
• The questionnaire was administered face-to-face
  to respondents by trained public health nurses.
• Representative for Croatian adult population in
  terms of its regional, gender and age structure.

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• Participants were asked about illnesses, health
  related behaviour, health related quality of
  life, use of health care services and subjective
  quality of life.
• Health related quality of life was measured by
• ? Health status questionnaire ( SF-36) which
  measure self perceived health status.

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SF-368 dimensions of health

• Physical functioning
• Role limitation due to physical problems
• Pain
• General health perception
• Energy / vitality
• Social functioning
• Role limitation due to emotional problems
• Mental health
• Scored 0-100

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Measure of Subjective Quality of Life

• How are you satisfied with your life as a whole?
• Completely Completely
• dissatisfied satisfied
• 0--------1----------2--------3--------4------5---
  ----6-------7------8------9------10
• Original scores were converted and presented in a
  form of percentage of scale maximum ( SM)

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RESULTS Quality of life (QoL)
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• Croatian average satisfaction with life
• Sample N 9,068 56.96 ? 26.06 SM
• Men N 2,888 56.22 ? 26.04 SM
• Women N 6,180 57.31 ? 26.07 SM
• p 0.064

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• Population mean
• 60.11 ? 25.12 SM (based on weighted values)
• N 3,479,134
• According to 1991 census
• population of Croatia 4 437 469

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Subjestive quality of lifeby age groups
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Self perceived economic status and QoL

• ? GDP per capita US 7,724.2
• ? Unemployment rate 18

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RESULTS Health
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Health status by dimensions
Dimension Mean Standard Deviation
Physical Functioning 70.20 29.93
Role limitation due to Physical problems 62.73 44.29
Pain 65.51 30.16
General Health Perception 55.47 22.81
Energy Vitality 53.99 22.32
Social Functioning 74.57 27.10
Role limitation due to Emotional problems 70.66 42.48
Mental Health 63.24 20.51
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Comparison with other countries...
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Health profiles gender differences
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Gender differences by age groups
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Summaries

• Older women in the worst position
• Low QoL and not very good health
• Difficulties in everyday functioning due to poor
  health

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- Regional differences exist- Mediterranean area
better
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Factor analysis SF-36 - Croatian sample




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Predictors of subjective quality of life (SQOL)

• Best predictors of SQOL
• Mental health (23 variance explained)
• General health (2.8 variance explained)
• All together 8 dimensions explained 27 of SQOL
• Subjective quality of life and health related
  quality of life must be measured
  independently/separately
• Different concept different content

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Conclusion(for further health surveys in Croatia)

• Importance of measuring QOL was recognised
• Subjective QOL incorporated in health surveys is
  independent of health related QOL measures so it
  will be measured independently.