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      Subjective expectations regarding ageing: a cross-sectional online population survey in Hungary

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          Abstract

          Background

          We aimed to investigate individuals’ subjective expectations regarding health and happiness alongside their provisions on life circumstances for older ages.

          Methods

          A cross-sectional online survey was performed involving a representative sample ( N = 1000; mean age 50.9, SD = 15.4; female 54.5%) in Hungary. Subjective expectations on health status (EQ-5D-3L/-5L, GALI, WHO-5), happiness (0–10 VAS), employment status, care time, and forms of care for ages 60, 70, 80, and 90 were surveyed.

          Results

          Current mean EQ-5D-5L was 0.869 (SD = 0.164) and happiness was 6.7 (SD = 2.4). Subjective life expectancy was 80.9 (SD = 11.1), and median expected retirement age was 65. Mean expected EQ-5D-5L for ages 60/70/80/90 was 0.761/0.684/0.554/0.402, and no activity limitations (GALI) were expected by 64%/40%/18%/14%, respectively. Expected happiness score was 6.8/6.7/6.2/5.7, and a decrease in mental well-being (WHO-5) was provisioned. A substantial increase in drug expenses and care time was anticipated, but only 52% thought to have extra income besides pension. The great majority expected to be helped by the family (77%/72%/53%/40%) if needed. Educational level, GALI, and longevity expectations were significant predictors of EQ-5D-5L expectations using a standard 5% significance level of decision. Current happiness was major determinant of expected future happiness.

          Conclusions

          Individuals expect a significant deterioration of health with age but only a moderate decrease in happiness. Overestimation of future activity limitations suggests a gap between statistical and subjective healthy life expectancy. The majority expects to rely on informal care in the elderly. Raise in retirement age is underestimated. Our results can be used as inputs for economic modelling of labor force participation and ageing.

          Electronic supplementary material

          The online version of this article (10.1007/s10198-019-01059-w) contains supplementary material, which is available to authorized users.

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          Most cited references25

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          Overview, Update, and Lessons Learned From the International EQ-5D-5L Valuation Work: Version 2 of the EQ-5D-5L Valuation Protocol

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            Population norms for the EQ-5D-3L: a cross-country analysis of population surveys for 20 countries

            This study provides EQ-5D population norms for 20 countries (N = 163,838), which 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. Descriptive EQ-5D data are provided for the total population, by gender and by seven age groups. Provided index values are based on European VAS for all countries, based on TTO for 11 countries and based on VAS for 10 countries. Important differences exist in EQ-5D reported health status across countries after standardizing for population structure. Self-reported health according to all five dimensions and EQ VAS generally decreased with increasing age and was lower for females. Mean self-rated EQ VAS scores varied from 70.4 to 83.3 in the total population by country. The prior living standards (GDP per capita) in the countries studied are correlated most with the EQ VAS scores (0.58), while unemployment appeared to be significantly correlated in people over the age of 45 only. A country’s expenditure on health care correlated moderately with higher ratings on the EQ VAS (0.55). EQ-5D norms can be used as reference data to assess the burden of disease of patients with specific conditions. Such information, in turn, can inform policy-making and assist in setting priorities in health care.
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              The reliability of the Minimum European Health Module.

              The Minimum European Health Module (MEHM) consists of 3 global questions concerning 3 health domains: self-perceived health, chronic conditions and long-term activity limitation. The objective of this paper is to evaluate the reliability of the MEHM. Participants of the Belgian Food Consumption Survey were interviewed twice: 170 individuals were selected for the MEHM reliability evaluation. For each of the 3 questions Pearson and Kappa coefficients were estimated. Analyses were stratified by gender, age, education, language and time between the interviews. The Pearson correlations are between 0.73 and 0.81. The Kappa estimates are good or excellent: 0.74 (self-perceived health), 0.77 (chronic conditions) and 0.68 (activity limitation). Also stratified analyses indicated in general an acceptable reliability. The MEHM has an acceptable reliability.
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                Author and article information

                Contributors
                marta.pentek@uni-corvinus.hu
                Journal
                Eur J Health Econ
                Eur J Health Econ
                The European Journal of Health Economics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1618-7598
                1618-7601
                20 May 2019
                20 May 2019
                2019
                : 20
                : Suppl 1
                : 17-30
                Affiliations
                [1 ]ISNI 0000 0000 9234 5858, GRID grid.17127.32, Department of Health Economics, , Corvinus University of Budapest, ; Fővám tér 8., Budapest, 1093 Hungary
                [2 ]ISNI 0000 0001 2294 6276, GRID grid.5591.8, Department of Comparative Economics, Institute of Business Economics, , Eötvös Loránd University, ; Szép u. 2, Budapest, 1053 Hungary
                [3 ]ISNI 0000 0001 2149 4407, GRID grid.5018.c, Premium Postdoctoral Research Programme, , Hungarian Academy of Sciences, ; Nádor u. 7, Budapest, 1051 Hungary
                [4 ]ISNI 0000 0000 9234 5858, GRID grid.17127.32, Doctoral School of Business and Management, , Corvinus University of Budapest, ; Fővám tér 8., Budapest, 1093 Hungary
                [5 ]ISNI 0000 0000 9234 5858, GRID grid.17127.32, Department of Macroeconomics, , Corvinus University of Budapest, ; Fővám tér 8., Budapest, 1093 Hungary
                Author information
                http://orcid.org/0000-0001-9636-6012
                http://orcid.org/0000-0001-9674-620X
                http://orcid.org/0000-0002-6095-2295
                http://orcid.org/0000-0003-2899-8557
                http://orcid.org/0000-0002-1992-6087
                http://orcid.org/0000-0002-9285-8746
                Article
                1059
                10.1007/s10198-019-01059-w
                6544751
                31111403
                1e0f9882-f1a8-41e8-8edb-51bd78c63170
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 26 March 2019
                : 14 April 2019
                Categories
                Original Paper
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2019

                Economics of health & social care
                subjective expectations,ageing,eq-5d-5l,happiness,employment,informal care,i19

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