title: Quality-of-life: a many-splendored thing? Belgian population norms and 34 potential determinants explored by beta regression.
abstract: To identify determinants of health-related quality-of-life in the Belgian population and to provide age-specific population norms of health-related quality-of-life.
  
  
  
  Between September 2010 and February 2011, a representative sample of 1774 persons (age 0-99) was surveyed using the standard Euroqol questionnaire (EQ-5D-3L) with a Visual Analogue Scale (VAS). Significant determinants were identified using multivariate beta (VAS) and one-inflated beta (EQ-5D) regression, the latter modelling the probability to be in perfect health separately from the average EQ-5D score if not in perfect health.
  
  
  
  Health-related quality-of-life depends largely on age and experience with severe disease. The probability to be in perfect health is highest for children. For 0-2 years children who are not in perfect health, proxies report EQ-5D and VAS scores as low as that of the elderly. Also smoking behaviour, educational attainment, pet ownership, working or having worked in health care, and potentially household size and 60+ living on their own (yes/no) are associated with health-related quality-of-life, whereas no association was found with gender, living in a single-parent home, educational attainment of mothers, alcohol consumption of 60+, having (grand-) children and the frequency of seeing them. The same determinants are significant for VAS and the probability to be in perfect health, but not for the average EQ-5D score if not in perfect health.
  
  
  
  The population norms provided can be used directly as input in health economic evaluations. Estimating health-related quality-of-life in children and developing statistical tools capturing the particular features of health-related quality-of-life measures are important areas for future research.
authors.affiliation: Centre for Health Economics Research and Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp - CDE R2.07, 2610, Wilrijk, Belgium. joke.bilcke@uantwerp.be.
authors.forename: Joke
authors.identifier: 0000-0001-5720-5291
authors.initials: J
authors.lastname: Bilcke
authors.affiliation: Centre for Health Economics Research and Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp - CDE R2.07, 2610, Wilrijk, Belgium.|Institute for Biostatistics and statistical Bioinformatics (I-BioStat), Hasselt University, Diepenbeek, Belgium.
authors.forename: Niel
authors.initials: N
authors.lastname: Hens
authors.affiliation: Centre for Health Economics Research and Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp - CDE R2.07, 2610, Wilrijk, Belgium.|School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia.
authors.forename: Philippe
authors.initials: P
authors.lastname: Beutels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001530:Belgium; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale; D055815:Young Adult
keywords: Alcohol; EQ-5D; Gender; Pet; Smoking; VAS