Psychometric Evaluation of the Health State Description Questionnaire in Chile: A Proposal for a Latent Variable Approach for Valuating Health States

Pedro Zitko; Ioannis Bakolis; Silia Vitoratou; Kia-Chong Chua; Paula Margozzini; Niina Markkula; Ricardo Araya

doi:10.1016/j.vhri.2021.06.002

Psychometric Evaluation of the Health State Description Questionnaire in Chile: A Proposal for a Latent Variable Approach for Valuating Health States

Value Health Reg Issues. 2021 Dec:26:142-149. doi: 10.1016/j.vhri.2021.06.002. Epub 2021 Aug 26.

Authors

Pedro Zitko¹, Ioannis Bakolis², Silia Vitoratou³, Kia-Chong Chua⁴, Paula Margozzini⁵, Niina Markkula⁶, Ricardo Araya⁷

Affiliations

¹ Health Services and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England, UK; Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: pedrozitko@gmail.com.
² Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England, UK; Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England, UK.
³ Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England, UK.
⁴ Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England, UK.
⁵ Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.
⁶ Department of Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland.
⁷ Centre of Global Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, England, UK.

PMID: 34454395
DOI: 10.1016/j.vhri.2021.06.002

Abstract

Background: A few instruments that identify and valuate health states are based on the International Classification of Functioning, Disability and Health States of the World Health Organization. One of them is the Health State Description (HSD) questionnaire first used in the World Health Survey (WHS) initiative (HSD-WHS), whose psychometric properties have not been evaluated in Chile. Additionally, the use of latent variables for the valuation process of health states has been scarcely investigated in the context of population health metrics. We aim to evaluate the psychometric properties and factorial structure of the HSD-WHS for Chile and describe a latent variable method for valuating health states associated with diseases.

Methods: We used data from the second Chilean National Health population-based survey from 2009 to 2010 (N = 5293). We explored the factorial structure of the HSD-WHS through exploratory and confirmatory factor analyses, the reliability, and the discriminant validity of the latent variable of disability. Disability weights for diseases were calculated using a linear regression model.

Results: We found an adequate goodness of fit for a second-order model with 9 factors corresponding to disability domains (Tucker-Lewis index = 0.99, comparative fit index = 0.99, root mean square error of approximation = 0.060), and good reliability estimates (standardized α = 0.91). The rescaled (between 0 and 100) latent variable of disability showed significant difference according to the explored variables. We estimated disability weights for the following: (1) depressive episode, 13.6 (12.1-15.2), (2) hypertension, 1.6 (0.0-3.3), and (3) diabetes, 5.0 (2.5-7.4).

Conclusions: This study supports the use of the HSD-WHS questionnaire in the Chilean population and a latent variable approach for valuating health states associated with diseases.

Keywords: Chile, disability; health state; health state valuation; health state values; psychometrics.

MeSH terms

Chile
Factor Analysis, Statistical
Humans
Psychometrics*
Reproducibility of Results
Surveys and Questionnaires