medigraphic.com
Instituto Nacional de Salud Pública

2006, Number 6

<< Back Next >>

salud publica mex 2006; 48 (6)

Health status identification and their relationship with socieconomics and geographic characteristics: a population survey analysis in México

Vargas-Palacios A, Gutiérrez JP, Carreón-Rodríguez V

Language: Spanish
References: 20
Page: 482-489
PDF size: 92.57 Kb.


ABSTRACT

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. Material and 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%. Conclusion. 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.


REFERENCES

  1. Murray CJL, Frenk J. Summary measures of population health in the context of the WHO framework for health system performance assessment. En: Murray CJL, Salomon A, Mathers C, Lopez A (comp). Summary measures of population health: concepts, ethics, measurement and applications. Ginebra: World Health Organization, 2002:1-12.

  2. Murray CJL, Salomon A, Mathers C. A critical examination of summary measures of population health. En: Murray CJL, Salomon A, Mathers C, Lopez A (comp). Summary measures of population health: concepts, ethics, measurement and applications. Ginebra: World Health Organization, 2002:13-40.

  3. Van der Maas P. Applications of summary measures of population health. En: Murray CJL, Salomon A, Mathers C, Lopez A (comp). Summary measures of population health: concepts, ethics, measurement and applications. Ginebra: World Health Organization, 2002:53-60.

  4. Salomon A, Colin D, Mathers C, Chatterji S, Sadana R, Üstün TB, et al. Quantifying individual levels of health: Definitions, concepts, and measurement issues. En: Murray CJL, Evans DB (comp). Health system performance assessment: debates, methods and empiricism. Ginebra: World Health Organization, 2003:301-319.

  5. Sadana R, Mathers C, Lopez A, Murray CJL, Iburg K. Comparative analyses of more than 50 household surveys on health status. En: Murray CJL, Salomon A, Mathers C, Lopez A (comp). Summary measures of population health: concepts, ethics, measurement and applications. Ginebra: World Health Organization, 2002: 369-387.

  6. Secretaría de Salud, México. Desempeño de los Sistemas de Salud. Salud: México 2002, Información para la rendición de cuentas. México, DF: Secretaría de Salud, 2003.

  7. Üstüm TB, Chatterji S, Villanueva M, Bendib L, Çelik C, Sadana R, et al. WHO Multi-country Survey Study on Health and Responsiveness 2000-2001. En: Murray CJL, Evans DB, (comp). Health system performance assessment: debates, methods and empiricism. Ginebra: World Health Organization, 2003:761-797.

  8. Murray CJL, Özaltin E, Tandon A, Salomon A, Sadana R, Chatterji S. Empirical evaluation of the anchoring vignette approach in health surveys. En: Murray CJL, Evans DB (comp) Health system performance assessment: debates, methods and empiricism. Ginebra: World Health Organization, 2003:369-401.

  9. Salomon A, Ajay T, Murray CJL. Comparability of self rated health: cross sectional multi-country survey using anchoring vignettes. BMJ 2004;328:258-264.

  10. Secretaría de Salud, México. Evaluación del Desempeño de los Sistemas de Salud, anexos estadísticos de la Encuesta Nacional de Evaluación del Desempeño (ENED 2002-2003). Dispnible en: http://evaluacion.salud.gob.mx/evaluacion/evaluacion.htm

  11. Murray CJL, Salomon A, Mathers C. The individual basis for summary measures of population health. En: Murray CJL, Salomon A, Mathers C, Lopez A (comp). Summary measures of population health: concepts, ethics, measurement and applications. Ginebra: World Health Organization, 2002:41-51.

  12. Palma-Coca O, Olaiz-Fernández GA. Metodología de la Encuesta Nacional de Evaluación del Desempeño. Salud Publica Mex 2005;47(supl 1): S66-S74.

  13. Sen A. Health: perception versus observation. BMJ 2002;324:860-861.

  14. Salomon A, Ajay T, Murray CJL. Unpacking health perceptions using anchoring vignettes. En: Murray CJL, Evans DB (comp). Health system performance assessment: debates, methods and empiricism. Ginebra: World Health Organization, 2003:401-409.

  15. Salomon A, Murray CJL, Üstün TB, Chatterji S. Health state valuations in summary measures of population health. En: Murray CJL, Evans DB (comp). Health system performance assessment: debates, methods and empiricism. Ginebra: World Health Organization, 2003:409-437.

  16. Damian J, Ruigomez A, Pastor V, Martin-Moreno JM. Determinants of self assessed health among Spanish older people living at home. J Epidemiol Community Health 1999;53:412-416.

  17. Fuchs VR. Reflections on the socio-economic correlates of health. J Health Econ 2004;23:653-661.

  18. Devlin N, Hansen P, Herbison P. Variations in self-reported health status: results from a New Zealand survey. N Z Med J 2000;113:517-520.

  19. Seculi E, Fuste J, Brugulat P, Junca S, Rue M, Guillen M. Health self-perception in men and women among the elderly. Gac Sanit 2001;15:217-223.

  20. Nogueira G, Teixeira M, Landmann C. Perception of health state and the use of vignettes to calibrate for socioeconomic status: results of the World Health Survey in Brazil, 2003. Cad Saude Publica 2005;21(supl):S65-S67.




2020     |     www.medigraphic.com