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Gesundheitswesen. 2010 Aug-Sep;72(8-9):476-86. doi: 10.1055/s-0029-1239508. Epub 2009 Oct 2.

[Health status of adults in Germany: results from a representative survey using the EuroQol 5D (EQ-5D)].

[Article in German]

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Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Neuherberg.



Over the past few years, the discussion on health-related quality of life (HRQL) has increased considerably in Germany as well. HRQL can be assessed by different dimensions of health, and it can be summarised by a single numerical value. This study intends to describe the HRQL of German adults based on individual valuations, to compare the results with those of an earlier study, to investigate the impact of using valuations based on given health states, and as an example of use to analyse socioeconomic differences using the EQ-5D.


The analyses are based on a representative survey in Germany, conducted by the Wort und Bild Verlag in 2006. HRQL has been assessed by the EuroQol 5D (EQ-5D). In the descriptive part, health was assessed by five descriptive questions. Next, valuations of overall health were elicitated from survey participants using a visual analogue scale (VAS) and, alternatively, taken from a different sample based on the time trade off (TTO) method. Five independent variables were included in the analysis: age, sex, educational level, per capita income, employment status. The results are compared with previous German evidence from the ESEMeD study.


Data were retrieved from 1 966 persons (aged 20 years or above); the response rate was 73%. In the descriptive part of the EQ-5D, the prevalence of some problems was especially high in the dimension pain/discomfort (31.9%). In contrast, the prevalence of extreme problems was very low in all five dimensions. The mean VAS value was 79.2. Considering the five dimensions, the VAS values and the TTO score, HRQL was mostly higher for men than for women, and mostly higher for the upper educational groups (as compared with the lower educational groups). Very similar associations were found when the independent variables are mutually controlled for, in logistic regressions (dependent variables: five dimensions) as well as in linear regressions (dependent variables: VAS value or TTO score). The linear regressions also showed that HRQL increases with increasing per capita income.


The EQ-5D provides a simple instrument for assessing HRQL. It can well detect health inequalities, and the results can be replicated in different studies. More research is needed on the techniques to valuate HRQL in population studies. The EQ-5D provides a tool to assess the HRQL of the German population. New reference figures have been presented for this, and it has been shown how health economic tools and research on health inequalities can be integrated.

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