title: Do Chinese have similar health-state preferences? A comparison of mainland Chinese and Singaporean Chinese.
abstract: BACKGROUND
  Little is known about whether health-state preferences differ among Chinese populations. This study compared the preference values for EQ-5D-5L health states between mainland Chinese and Singaporean Chinese.
  
  
  METHODS
  The preference values for ten EQ-5D-5L health states were elicited from general population samples of mainland Chinese and Singaporeans. In computer-assisted self-interviews, each participant completed five time trade-off (TTO) tasks to value five different EQ-5D-5L health states. The difference in TTO values between mainland Chinese and Singaporean Chinese was examined using random-effects linear regression and logistic regression models.
  
  
  RESULTS
  A total of 194 eligible mainland Chinese and 145 eligible Singaporean Chinese provided data for this study. All ten health states considered, the mean TTO value was 0.18 for Singaporean Chinese and 0.35 for mainland Chinese, with the unadjusted and adjusted difference [95% confidence interval (CI)] being -0.17 (-0.28, -0.07) and -0.16 (-0.27, -0.05). Singaporean Chinese had substantially lower TTO values than mainland Chinese for states with severe or extreme problems, with the adjusted difference being -0.30 (95% CI -0.42, -0.17). On the other hand, Singaporean Chinese and mainland Chinese had similar TTO values for states with mild or moderate problems, with the adjusted (95% CI) difference being 0.04 (-0.07, 0.15). Logistic regression analysis showed that Singaporean Chinese were more likely to rate health states with severe or extreme problems as worse than death compared to mainland Chinese.
  
  
  CONCLUSIONS
  Mainland Chinese and Singaporean Chinese have different preferences for EQ-5D-5L health states, supporting the development of local value sets for the EQ-5D-5L instrument for the two populations.
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Block MD3, Singapore, 117597, Singapore.
authors.forename: P
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, MD, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Li
authors.affiliation: National School of Development, Peking University, Beijing, China.
authors.forename: G G
authors.initials: GG
authors.lastname: Liu
authors.affiliation: Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.
authors.forename: J
authors.initials: J
authors.lastname: Thumboo
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Block MD3, Singapore, 117597, Singapore. nan_luo@nuhs.edu.sg.
authors.forename: N
authors.initials: N
authors.lastname: Luo
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002681:China; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D012846:Singapore; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: EQ-5D-5L; Health-state preferences; Mainland Chinese; Singaporean Chinese; Time trade-off