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Socio-demographic, clinical characteristics and utilization of mental health care services associated with SF-6D utility scores in patients with mental disorders: contributions of the quantile regression

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Abstract

Purpose

Health-related quality of life (HRQoL) is a widely used concept in the assessment of health care. Some generic HRQoL instruments, based on specific algorithms, can generate utility scores which reflect the preferences of the general population for the different health states described by the instrument. This study aimed to investigate the relationships between utility scores and potentially associated factors in patients with mental disorders followed in inpatient and/or outpatient care settings using two statistical methods.

Methods

Patients were recruited in four psychiatric sectors in France. Patient responses to the SF-36 generic HRQoL instrument were used to calculate SF-6D utility scores. The relationships between utility scores and patient socio-demographic, clinical characteristics, and mental health care utilization, considered as potentially associated factors, were studied using OLS and quantile regressions.

Results

One hundred and seventy six patients were included. Women, severely ill patients and those hospitalized full-time tended to report lower utility scores, whereas psychotic disorders (as opposed to mood disorders) and part-time care were associated with higher scores. The quantile regression highlighted that the size of the associations between the utility scores and some patient characteristics varied along with the utility score distribution, and provided more accurate estimated values than OLS regression.

Conclusions

The quantile regression may constitute a relevant complement for the analysis of factors associated with utility scores. For policy decision-making, the association of full-time hospitalization with lower utility scores while part-time care was associated with higher scores supports the further development of alternatives to full-time hospitalizations.

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Acknowledgements

The authors are indebted to the Daumézon hospital (Centre Hospitalier Départemental Georges Daumézon) staff, in particular the heads of the care services G01, G02, G05, G08, and of the department of medical information as well as their teams, for its collaboration and support for the implementation of the survey. The authors also thank Anaïs Le Jeannic, Marie-Amélie Vinet, and Thomas Lefevre for their participation in the data collection, Sandrine Simon for her support for the design of the survey questionnaire as well as Karen Berg Brigham for her valuable comments on the manuscript.

Funding

This research was undertaken with the support of the FondaMental Foundation, a foundation of scientific cooperation, as well as with the joint support of the French Ministry of Health, General Directorate of Health (Direction Générale de la Santé) and Directorate of Research, Studies, Evaluation and Statistics (Direction de la Recherche, des Etudes, de l’Evaluation et des Statistiques); the general scheme of the statutory health insurance system (Caisse Nationale d’Assurance Maladies des Travailleurs Salariés); the scheme for self-employed people (Régime Social des Indépendants); the National Solidarity Fund for Autonomy (Caisse Nationale de Solidarité pour l’Autonomie) and the National Institute for Prevention and Health Education (Insitut National de Prévention et d’Education pour la Santé) in the context of IReSP’s 2010 call for research projects.

Author information

Authors and Affiliations

  1. AP-HP, URC Eco Ile-de-France, 1, place du parvis Notre Dame, 75004, Paris, France

    Amélie Prigent PhD & Karine Chevreul MD, PhD

  2. University Paris Diderot, Sorbonne Paris Cité, ECEVE, UMR 1123, 75010, Paris, France

    Amélie Prigent PhD & Karine Chevreul MD, PhD

  3. Inserm, ECEVE, U1123, 75010, Paris, France

    Amélie Prigent PhD & Karine Chevreul MD, PhD

  4. Fondation FondaMental, French National Science Foundation, Créteil, 94000, France

    Amélie Prigent PhD & Karine Chevreul MD, PhD

  5. Centre Hospitalier Départemental Georges Daumézon, Fleury-Les-Aubrais, 45400, France

    Blaise Kamendje-Tchokobou MD

  6. Agence Régionale de Santé Centre-Val de Loire, Cité administrative Coligny, 131 Rue du Faubourg Bannier, 45000, Orléans, France

    Blaise Kamendje-Tchokobou MD

  7. Department of Public Health, AP-HP, Robert-Debré University Hospital, 75019, Paris, France

    Karine Chevreul MD, PhD

Authors
  1. Amélie Prigent PhD
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  2. Blaise Kamendje-Tchokobou MD
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  3. Karine Chevreul MD, PhD
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Correspondence to Amélie Prigent PhD.

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Conflict of interest

Amélie Prigent received a grant from the FondaMental foundation to perform this work. Other authors declare that they have no conflict of interest.

Ethical approval

Ethical approvals for this study were obtained from the French advisory committee on data processing in the health domain research (comité consultatif sur le traitement de l’information en matière de recherche dans le domaine de la santé (CCTIRS), the French national committee of data processing and freedom (commission nationale de l’informatique et des libertés (CNIL)), and the ethical research committee (comité de protection des personnes (CPP)) Ile-de-France IX.

Informed consent

As this study was a non-interventional study, written informed consent was not required. However, each included patient has been informed of the study’s objectives and of the types of data collected (verbally and through a letter of information). Only patients who agreed to participate in the study were included after their non-opposition to participate was orally collected.

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Prigent, A., Kamendje-Tchokobou, B. & Chevreul, K. Socio-demographic, clinical characteristics and utilization of mental health care services associated with SF-6D utility scores in patients with mental disorders: contributions of the quantile regression . Qual Life Res 26, 3035–3048 (2017). https://doi.org/10.1007/s11136-017-1623-4

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