LAUSR

Health-related quality of life outcomes are increasingly used to monitor population health and health inequalities, and to assess the (cost-)effectiveness of health interventions. The EQ-5D-5L has been included in the Belgian Health Interview Survey (BHIS), providing a new source of population-based self-perceived health status information. The aim of this study is to estimate Belgian population norms for the EQ-5D-5L by sex, age, and region, and to analyse its association with educational attainment. The BHIS 2013 and 2018 provided EQ-5D-5L data for a nationally representative sample of the Belgian population. The dimension scores and index values were analysed using logistic regression and linear regression, respectively, taking into account the survey design. The majority of respondents reported problems of pain/discomfort, while over a quarter reported problems of anxiety/depression in both surveys. The average index value was 0.81 in 2013 and decreased significantly to 0.79 in 2018. Women reported more problems on the dimensions, but particularly on anxiety/depression and pain/discomfort, resulting in significantly lower index values. Problems with mobility, self-care, and usual activities showed a sharp increase after the age of 80 years. Consequently, index values decreased significantly by age. Lower education was associated with a higher prevalence of problems for all dimensions except pain/discomfort in 2013 and anxiety/depression in 2018, and with a significantly lower index value. This paper presents the first nationally representative Belgian population norms using the EQ-5D-5L. Inclusion of the EQ-5D in future surveys will allow monitoring over time of self-reported health, disease burden, and health inequalities. This study is the first to provide Belgian population norms for the EQ-5D-5L and consequently increases the evidence base regarding country-specific population norms. Our results help policy makers in understanding and monitoring the self-perceived health status of the Belgian population according to age, gender, and educational attainment.