[Health status identification and their relationship with socieconomics and geographic characteristics: a population survey analysis in México].
OBJECTIVE
To estimate the effectiveness of using standardized health vignettes to adjust self-reported health taking into account household and community variables to correct for systematic bias.


METHODS
The national health survey "Evaluación del Desempeño 2002" (Mexican component of the World Health Survey) was used. This survey analyzed subject's health perception based on their responses to hypothetical questions referring to third parties in the vignettes within eight domains. Variations in responses were attributed to socio-demographic, socioeconomic, community, differences of the subjects. To assess those variations, an index for each domain was constructed and used as a variable in a series of linear regression models to estimate the relation between health perceptions, self-reported health, socioeconomic and socio-demographic characteristics.


RESULTS
The health perception index derived from the vignettes showed a positive, logarithmic correlation with household expenditure for each health domain, after controlling for socio-demographic, health and community characteristics. No relationship was found between the health status described in the vignettes and self-reported health status. In no case was the explanatory power above 10%.


CONCLUSIONS
The low explanatory power of the models, and the lack of correlation between self reported health status and the health perception index, suggest that the variability in the vignettes responses cannot be explained by differences in self-reported health status or socioeconomic and socio-demographic characteristics. These results from Mexico suggest that vignette-based methods to correct for systematic variability in perception of own health status are of limited efficacy and reinforce the importance of collecting objective measures of health status in health surveys.
Vargas-Palacios
Armando
A
División de Evaluación y Economía de la Salud, Centro de Investigaci6n en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, México.
Gutiérrez
Juan Pablo
JP
Carreón-Rodríguez
Víctor
V
D000328:Adult; D018592:Cross-Over Studies; D004493:Education; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D008800:Mexico; D009790:Occupations; D012649:Self Concept; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014944:World Health Organization