Rehabilitation and care after hip fracture: a cost-utility analysis of stepped-wedge cluster randomized trial.

Objective: To estimate the effectiveness and costs of Rehabilitation for Life (RFL) compared with usual rehabilitation and care after hip fracture to determine which course offered the most value for money.

Design: Cost-utility analysis.

Patient: Community-dwelling patients aged 65+ after hip fracture.

The influence of parents' and partner's education on own health behaviours.

The link between educational attainment and multiple health behaviours has been explained in various ways. This paper provides new insights into the social patterning in health behaviours by investigating the influence of parents' and partners' educational attainments on a composite indicator that integrates the four commonly studied lifestyle behaviours (smoking, alcohol, physical activity and BMI). Two key outcome indicators of interests were created to reflect both ends of the "healthy - unhealthy spectrum".

The relative importance of education and health behaviour for health and wellbeing.

Background: Indicators of socioeconomic position (SEP) and health behaviours (HB) are widely used predictors of health variations. Their relative importance is hard to establish, because HB takes a mediating role in the link between SEP and health. We aim to provide new knowledge on how SEP and HB are related to health and wellbeing.

Related variations: A novel approach for detecting patterns of regional variations in healthcare utilisation rates.

Regional variations in healthcare utilisation rates are ubiquitous and persistent. In settings where an aggregate national health service budget is allocated primarily on a per capita basis, little regional variation in total healthcare utilisation rates will be observed. However, for specific treatments, large variations in utilisation rates are observed, iymplying a substitution effect at some point in service delivery.

Inequality in quality-adjusted life expectancy by educational attainment in Norway: an observational study.

Background: Health inequalities are often assessed in terms of life expectancy or health-related quality of life (HRQoL). Few studies combine both aspects into quality-adjusted life expectancy (QALE) to derive comprehensive estimates of lifetime health inequality. Furthermore, little is known about the sensitivity of estimated inequalities in QALE to different sources of HRQoL information.

Amplified disparities: The association between spousal education and own health.

Positive associations between own educational attainment and own health have been extensively documented. Studies have also shown spousal educational attainment to be associated with own health. This paper investigates the extent to which spousal education contributes to the social gradient in health, net of own education; and whether parts of a seeming spousal education effect are attributable to differences in early-life human capital, as measured by respondents' height and childhood living standard.

Extending the EQ-5D: the case for a complementary set of 4 psycho-social dimensions.

Objectives: The EQ-5D is the most widely applied preference-based health-related quality of life measure. However, concerns have been raised that the existing dimensional structure lacks sufficient components of mental and social aspects of health. This study empirically explored the performance of a coherent set of four psycho-social bolt-ons: Vitality; Sleep; Personal relationships; and Social isolation.

Inequality of opportunity in a land of equal opportunities: The impact of parents' health and wealth on their offspring's quality of life in Norway.

Background: The literature on Inequality of opportunity (IOp) in health distinguishes between circumstances that lie outside of own control vs. efforts that - to varying extents - are within one's control. From the perspective of IOp, this paper aims to explain variations in individuals' health-related quality of life (HRQoL) by focusing on two separate sets of variables that clearly lie outside of own control: Parents' health is measured by their experience of somatic diseases, psychological problems and any substance abuse, while parents' wealth is indicated by childhood financial conditions (CFC).

Combining education and income into a socioeconomic position score for use in studies of health inequalities.

Background: In studies of social inequalities in health, there is no consensus on the best measure of socioeconomic position (SEP). Moreover, subjective indicators are increasingly used to measure SEP. The aim of this paper was to develop a composite score for SEP based on weighted combinations of education and income in estimating subjective SEP, and examine how this score performs in predicting inequalities in health-related quality of life (HRQoL).

How is your life? understanding the relative importance of life domains amongst older adults, and their associations with self-perceived COVID-19 impacts.

Purpose: This study aims to provide new knowledge on the relative importance of key life domains amongst older adults, and how the Coronavirus pandemic has influenced their life (domain) satisfaction.

Methods: A cross-sectional survey was administrated to an online panel of the general public aged 65 years and older in Australia from 28 April to 26 May 2020. Life satisfaction was measured by the Personal Wellbeing Index (PWI, including both global life satisfaction and life domain satisfaction).

Who keeps on working? The importance of resilience for labour market participation.

Background: It is widely recognized that individuals' health and educational attainments, commonly referred to as their human capital, are important determinants for their labour market participation (LMP). What is less recognised is the influence of individuals' latent resilience traits on their ability to sustain LMP after experiencing an adversity such as a health shock.

Aim: We investigate the extent to which resilience is independently associated with LMP and moderates the effect of health shocks on LMP.

Explaining subjective social status in two countries: The relative importance of education, occupation, income and childhood circumstances.

In the literature on social inequalities in health, subjective socioeconomic position (SEP) is increasingly applied as a determinant of health, motivated by the hypothesis that having a high subjective SEP is health-enhancing. However, the relative importance of determinants of subjective SEP is not well understood. Objective SEP indicators, such as education, occupation and income, are assumed to determine individuals' position in the status hierarchy.

Health and wellbeing in Norway: Population norms and the social gradient.

Measures of health-related quality of life are important in health technology assessments, and useful when analysing health inequalities across population sub-groups. This paper provides population norms on health and wellbeing in Norway based on two waves of a comprehensive health survey: Wave 6 of The Tromsø Study conducted in 2007/08 (N = 12,981) and Wave 7 conducted in 2015/16 (N = 21,083). By use of these data, the paper aims to provide new insight on how different measures of health and wellbeing, and different indicators for socio-economic position, will affect the magnitude of a reported social gradient in health.

Filling the psycho-social gap in the EQ-5D: the empirical support for four bolt-on dimensions.

Purpose: The EQ-5D is the most widely applied generic preference-based measure (GPBM) of health-related quality of life (HRQoL). Much concern has been raised that its descriptive system is lacking psycho-social dimensions. A recent paper in this journal provided theoretical support for four dimensions to fill this gap.

Associations between utilization rates and patients' health: a study of spine surgery and patient-reported outcomes (EQ-5D and ODI).

Background: A vast body of literature has documented regional variations in healthcare utilization rates. The extent to which such variations are "unwarranted" critically depends on whether there are corresponding variations in patients' needs. Using a unique medical registry, the current paper investigated any associations between utilization rates and patients' needs, as measured by two patient-reported outcome measures (PROMs).

A conceptual map of health-related quality of life dimensions: key lessons for a new instrument.

Purpose: Quality-adjusted life years (QALYs) represent a critical metric in economic evaluations impacting key healthcare decisions in many countries. However, there is widespread disagreement as to which is the best of the health state utility (HSU) instruments that are designed to measure the Q in the QALY. Instruments differ in their descriptive systems as well as their valuation methodologies; that is, they simply measure different things.

Cost-Effectiveness of Telemedicine in Remote Orthopedic Consultations: Randomized Controlled Trial.

Background: Telemedicine consultations using real-time videoconferencing has the potential to improve access and quality of care, avoid patient travels, and reduce health care costs.

Objective: The aim of this study was to examine the cost-effectiveness of an orthopedic videoconferencing service between the University Hospital of North Norway and a regional medical center in a remote community located 148 km away.

Methods: An economic evaluation based on a randomized controlled trial of 389 patients (559 consultations) referred to the hospital for an orthopedic outpatient consultation was conducted.

Correction: Violence Affects Physical and Mental Health Differently: The General Population Based Tromsø Study.

[This corrects the article DOI: 10.1371/journal.pone.

Testing alternative regression models to predict utilities: mapping the QLQ-C30 onto the EQ-5D-5L and the SF-6D.

Purpose: The purpose of the study was to compare alternative statistical techniques to find the best approach for converting QLQ-C30 scores onto EQ-5D-5L and SF-6D utilities, and to estimate the mapping algorithms that best predict these health state utilities.

Methods: 772 cancer patients described their health along the cancer-specific instrument (QLQ-C30) and two generic preference-based instruments (EQ-5D-5L and SF-6D). Seven alternative regression models were applied: ordinary least squares, generalized linear model, extended estimating equations (EEE), fractional regression model, beta binomial (BB) regression, logistic quantile regression and censored least absolute deviation.

Exploring the causal and effect nature of EQ-5D dimensions: an application of confirmatory tetrad analysis and confirmatory factor analysis.

Background: The relationship between the various items in an HRQoL instrument is a key aspect of interpreting and understanding preference weights. The aims of this paper were i) to use theoretical models of HRQoL to develop a conceptual framework for causal and effect relationships among the five dimensions of the EQ-5D instrument, and ii) to empirically test this framework.

Methods: A conceptual framework depicts the symptom dimensions [Pain/discomfort (PD) and Anxiety/depression (AD)] as causal indicators that drive a change in the effect indicators of activity/participation [Mobility (MO), Self-care (SC) and Usual activities (UA)], where MO has an intermediate position between PD and the other two effect dimensions (SC and UA).

Assessment of outcome measures for cost-utility analysis in depression: mapping depression scales onto the EQ-5D-5L.

Background: Many clinical studies including mental health interventions do not use a health state utility instrument, which is essential for producing quality-adjusted life years. In the absence of such utility instrument, mapping algorithms can be applied to estimate utilities from a disease-specific instrument.AimsWe aim to develop mapping algorithms from two widely used depression scales; the Depression Anxiety Stress Scales (DASS-21) and the Kessler Psychological Distress Scale (K-10), onto the most widely used health state utility instrument, the EQ-5D-5L, using eight country-specific value sets.

Do country-specific preference weights matter in the choice of mapping algorithms? The case of mapping the Diabetes-39 onto eight country-specific EQ-5D-5L value sets.

Purpose: To develop mapping algorithms that transform Diabetes-39 (D-39) scores onto EQ-5D-5L utility values for each of eight recently published country-specific EQ-5D-5L value sets, and to compare mapping functions across the EQ-5D-5L value sets.

Methods: Data include 924 individuals with self-reported diabetes from six countries. The D-39 dimensions, age and gender were used as potential predictors for EQ-5D-5L utilities, which were scored using value sets from eight countries (England, Netherland, Spain, Canada, Uruguay, China, Japan and Korea).