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EQ-5D is a standardized health-related quality of life questionnaire developed by the EuroQol Group in order to provide a simple, generic measure of health for clinical and economic appraisal. Applicable to a wide range of health conditions and treatments, it provides a simple descriptive profile, a self-report visual analogue scale and a single index value for health status that can be used in the clinical and economic evaluation of health care as well as in population health surveys.

The EuroQol Group is frequently asked to provide EQ-5D population reference data for a specific country or international region. Such data can be used to compare profiles for patients with specific conditions with data for the average person in the general population in a similar age and/or gender group. Also the burden of disease in question can be compared to the general population’s health.

The current book presents the population norms for 24 countries and some of their regions as well as results of four additional analyses of population health based on EQ-5D, including EQ-5D index norms.

This chapter presents the data sources and methods of the book. General population surveys are accumulated from 24 countries (Table 2.1). Descriptive statistics are used to provide EQ-5D population norms by age and gender categories for EQ VAS, EQ-5D index values, and for the five dimensions. Correlations between country-specific EQ-5D data (EQ VAS and 5 dimensions) and country-specific economic and health system macro indicators are calculated in the cross-country analysis. Odds ratios and the health concentration index methodology are used in the socio-demographic analysis of EQ-5D data.

This chapter presents the population norm data using EQ-5D for each country. EQ-5D norms are reported for EQ VAS and EQ-5D index values, and for self-reported problems on each of the five dimensions of the EQ-5D descriptive system, all classified by age and gender. These EQ-5D norms can be used as reference data to compare patients with specific conditions and to assess the burden of the disease in question.

This chapter demonstrates that cross-country differences exist in EQ-5D outcomes after the population data is standardized for demographic differences. These cross-country differences in the general level of health are explained by looking at macro data on the economic and health system characteristics of each country. Results show that it is the prior living standards of a country that mostly explain cross-country differences in self-reported health.

This chapter specifically addresses the distribution of health within the population and the degree to which age, gender, education level and country are responsible for inequalities in self-reported health. Usual activities and pain/discomfort were the highest contributors to overall inequalities in self-assessed health in most countries. Education had a consistent role in explaining a lower level of self-reported health. The level of inequalities in self-assessed health and the health inequality profile by EQ-5D dimension differed substantially across countries, deserving the attention of policy makers within each country.

Future population surveys using EQ-5D-3L or EQ-5D-5L may be integrated into the EuroQol archive of population survey datasets as they become available. Researchers planning to conduct new population surveys using EQ-5D should contact the EuroQol Group Executive Office (userinformationservice@euroqol.org).