Towards a Central-Eastern European EQ-5D-3L population norm: comparing data from Hungarian, Polish and Slovenian population studies

Zsombor Zrubka, Dominik Golicki, Valentina Prevolnik-Rupel, Petra Baji, Fanni Rencz, Valentin Brodszky, L. Gulácsi, Márta Péntek

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Background: EQ-5D-3L population data are available only from Hungary, Poland and Slovenia in Central and Eastern Europe (CEE). We aimed to compare the accessible studies and estimate a regional EQ-5D-3L population norm for CEE. Methods: A combined dataset using patient-level data of 8850 respondents was created. Based on the European Census of 2011, regional population norm estimates were calibrated by gender, age and education for the joint citizenry of 11 CEE countries. Results: EQ-5D-3L health states were available for 6926 and EQ VAS scores for 6569 respondents. Demographic characteristics of the samples reflected the recruitment methods (Hungary: online; Slovenia: postal survey, Poland: personal interviews). Occurrence of problems differed significantly by educational level in all the five dimensions (p < 0.001). The inter-country differences persisted after controlling for demographic variables. The estimated EQ-5D-3L index CEE norms with UK tariffs for age groups 18–24, 25–34, 35–44, 45–54, 55–64, 65–74 and 75 + were 0.911, 0.912, 0.871, 0.817, 0.762, 0.743 and 0.636 for males and 0.908, 0.888, 0.867, 0.788, 0.752, 0.68 and 0.584 for females, respectively. Estimates were provided also using Polish, European and Slovenian value sets. Conclusions: Besides gender and age, education should be considered during the design and interpretation of quality-of-life studies in CEE. The estimated regional EQ-5D-3L population norm may be used as a benchmark by CEE countries with lack of local dataset. However, the substantial inter-country differences in health status and scarcity of data over age 65 call for harmonized country-specific EQ-5D-3L population norm studies in the CEE region.

Original languageEnglish
Pages (from-to)141-154
Number of pages14
JournalEuropean Journal of Health Economics
Publication statusPublished - Jun 1 2019



  • Central-Eastern Europe
  • EQ-5D-3L
  • Hungary
  • Poland
  • Population norm
  • Slovenia

ASJC Scopus subject areas

  • Economics, Econometrics and Finance (miscellaneous)
  • Health Policy

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