Health-related quality of life among Indian population: The EQ-5D population norms for India

Background The EuroQol 5 dimensions (EQ-5D) is the most used generic health -re-lated quality of life (HRQoL) instrument for measuring population health and health outcomes. Since there are no EuroQol 5 dimensions 5 levels (EQ-5D-5L) population norms available for India, this study developed the Indian population norms for the EQ-5D-5L. The potential influencing factors of HRQoL of the Indian population have been identified.Methods The data was collected alongside the Indian EQ-5D-5L valuation study (De-velopment of an EQ-5D Value Set for India Using an Extended Design: DEVINE Study). A cross-sectional survey of 3548 adult respondents was conducted across five states of India, in which respondents were asked to report their own health states using the EQ-5D-5L descriptive system and the EuroQol Visual Analog Scale (EQ VAS). The utility score was calculated using the EQ-5D-5L value set based on the preferences of the Indian population. Norm scores were generated for age, sex, and other important socio-demographic variables. The proportion of patients reporting problems in dif-ferent dimensions of EQ-5D-5L was assessed. The impact of socio-economic determi-nants on health-related quality of life was evaluated using multiple linear regression.Results The mean EQ VAS score of the Indian population is 75.18 (95% confidence in-terval (CI) = 74.50-75.90), whereas mean utility score is 0.848 (95% CI = 0.840-0.857). The EQ VAS scores, and utility scores decreased with age. Males reported higher EQ VAS values than females. The highest mean utility score was observed for males of <20 years (0.936), whereas the lowest mean score was observed for females of >70 years (0.488). The mean VAS score ranged between 85.24 for females of <20 years and 50.67 for females of >70 years. Highest problems were reported in the dimension of "pain / discomfort", closely followed by "anxiety / depression". Age, educational qual-ification, marital status, substance abuse, presence of ailments, state / region of resi-dence, number of dependent members in the household, and time spent on mobile are the significant determinants of HRQoL of Indian population.Conclusions These population norms will be used as reference values for compara-tive purposes in future Indian studies. Economic evaluations can use these average age-specific HRQoL population norms to value the health-state of not having the spe-cific disease under investigation.