Racial differences in patients' perceptions of debilitated health states.
OBJECTIVE
To determine health utility scores for specific debilitated health states and to identify whether race or other demographic differences predict significant variation in these utility scores.


METHODS
Utility analysis.


METHODS
A community hospital general internal medicine clinic, a private internal medicine practice, and a private pulmonary medicine practice.


METHODS
Sixty-four consecutive patients aged 50 to 75 years awaiting appointments. In order to participate, patients at the pulmonary clinic had to meet prespecified criteria of breathing impairment.


METHODS
Individuals' strength of preference concerning specific states of limited physical function as measured by the standard gamble technique.


RESULTS
Mean utility scores used to quantitate limitations in physical function were extremely low. Using a scale for which 0 represented death and 1.0 represented normal health, limitation in activities of daily living was rated 0. 19 (95% confidence interval [CI] 0.13, 0.25), tolerance of only bed-to-chair ambulation 0.17 (95% CI 0.11, 0.23), and permanent nursing home placement 0.16 (95% CI 0.10, 0.22). Bivariate analysis identified female gender and African-American race as predictors of higher utility scores ( p </=.05). In multiple regression analysis, only race remained statistically significant ( p </=.02 for all three outcome variables).


CONCLUSIONS
Comparisons of African-American values with those of whites concerning defined states of debility demonstrate greater than threefold increases in utility scores. This finding suggests that racial differences need to be taken into account when studying the effects of medical interventions on quality of life.
Cykert
S
S
Division of General Internal Medicine and Clinical Epidemiology of the University of North Carolina School of Medicine, Chapel Hill, USA.
Joines
J D
JD
Kissling
G
G
Hansen
C J
CJ
D000203:Activities of Daily Living; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000704:Analysis of Variance; D001293:Attitude to Death / Q000208:ethnology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology*