Published online December 3, 2007
PEDIATRICS Vol. 121 No. 1 January 2008, pp. e118-e126 (doi:10.1542/peds.2007-0480)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Simon, A. E.
Right arrow Articles by Forrest, C. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Simon, A. E.
Right arrow Articles by Forrest, C. B.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Assessment of Children's Health-Related Quality of Life in the United States With a Multidimensional Index

Alan E. Simon, MDa, Kitty S. Chan, PhDb and Christopher B. Forrest, MD, PhDc

a Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland
b Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
c Institute to Transform and Advance Children's Healthcare, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

OBJECTIVE. Using nationally representative data, we examined biological, medical system, and sociodemographic factors that are associated with health-related quality of life as measured by a multidimensional index that accounts for a wide range of child health domains.

METHODS. Children aged ≥6 years (N = 69031) were drawn from the 2003/2004 National Survey of Children's Health. A random 25% sample was used to create a 12-item index of health-related quality of life with a range of 0 to 100, based on the conceptual framework of the Child Health and Illness Profile. Bivariate and multivariable regression analyses were conducted to identify the unadjusted and independent associations of key biological, medical system, and sociodemographic variables with health-related quality of life.

RESULTS. The index mean was 72.3 (SD: 14.5), median value was 73.7, and range was 11.1 to 99.9. Only 0.2% of children had a score at the ceiling. In multivariable regression analysis, the following variables were independently associated with lower health-related quality of life: biological factors (greater disease burden, severe asthma, and overweight status); medical system factors (unmet medical needs, lack of a regular health care provider, Medicaid insurance, or being uninsured previously during the year); and sociodemographic factors (older age groups, lower family education, single-mother family, having a smoker in the household, black race, and poverty).

CONCLUSIONS. Health-related quality of life in the United States is poorest for children and youth in lower socioeconomic status groups, those with access barriers, adolescents compared with children, and individuals with medical conditions. A multidimensional health-related quality-of-life index is an alternative to conventional measures (eg, mortality) for national monitoring of child health.

Key Words: quality of life • child health • National Survey of Children's Health

Abbreviations: HRQoL—health-related quality of life • IOM—Institute of Medicine • NSCH—National Survey of Children's Health • CHIP—Child Health and Illness Profile

Accepted Jun 8, 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Arch Pediatr Adolesc MedHome page
M. R. Rank and T. A. Hirschl
Estimating the Risk of Food Stamp Use and Impoverishment During Childhood
Arch Pediatr Adolesc Med, November 1, 2009; 163(11): 994 - 999.
[Abstract] [Full Text] [PDF]