ABSTRACT
BACKGROUND: The COVID-19 pandemic has impacted various aspects of people's life and wellbeing around the world. This study aimed to examine the impact of the COVID-19 pandemic on health-related quality of life (HRQL), measured by the EQ-5D-5L, amongst the general population in the province of Alberta, Canada, and explore whether the impact varied across population subgroups based on age, gender, and dwelling. METHODS: Data came from two waves of a repeated cross-sectional population-based survey, the COVID-19 Experiences and Impact Survey, administered by the Health Quality Council of Alberta. The first data collection (survey 1: n = 8790) was during May/June 2020 and the second (survey 2: n = 9263) during Oct 2020. We examined the comparability of weighted survey data and their representativeness to Alberta's general population. We then explored between-survey differences in EQ-5D-5L index, EQ-VAS and dimension responses, and differences across subgroups within each survey. We compared HRQL of the pooled sample (survey 1&2) with the Alberta population norms data from the pre-pandemic period. RESULTS: Mean EQ-5D-5L index and EQ-VAS scores were 0.81 (0.15) and 72.54 (18.57), and 0.82 (0.14) and 71.98 (18.96) in surveys 1 and 2, respectively. The anxiety/depression dimension had the most reported problems (survey 1: 69.5%, survey 2: 70.2%). Respondents aged 16-24 or 75 and older, who identified themselves as a woman, or residing in urban areas had significantly lower EQ-5D-5L index scores compared to their counterparts in both surveys. Between-survey differences were not substantially different. Comparing the pooled sample with the pre-pandemic Alberta population norms, EQ-5D-5L index scores (0.82 vs. 0.84) and EQ-VAS scores (72.26 vs. 77.40) were significantly lower, and respondents aged 16-44, women, or urban residents were more impacted. More problems were reported in the anxiety/depression (69.9% vs. 37.2%) and usual activities dimensions (40.5% vs. 26.0%) during the pandemic period, especially for respondents aged 16-44, women, and those residing in urban areas. CONCLUSIONS: Lower HRQL was reported during the COVID-19 pandemic compared to pre-pandemic HRQL in this population, with anxiety/depression and usual activities affected the most. People who were younger, women, and residing in urban areas were most impacted. The government responses to COVID-19 policies during population outbreaks should consider the needs of Albertans in these particular groups.
ABSTRACT
OBJECTIVES: To examine the impact of COVID-19 pandemic on health-related quality of life (HRQL) of adults visiting emergency departments (ED) and primary care (PC) settings in Alberta, Canada, and explore whether this impact varies across demographic subgroups. METHODS: Data from two repeated cross-sectional surveys that measured HRQL using EQ-5D-5L were used; "pre-COVID" Sept 2019-Feb 2020 (ED, N=5927; PC, N=317), "Wave-1" Mar 2020-Aug 2020 (ED, N=4781; PC, N=375), and "Wave-2" Sept 2020-Jan 2021 (ED, N=4443; PC, N=327). RESULTS: In the ED sample, there were decrements in mild-extreme problems of 3.7% in mobility and 4.1% in usual activities from pre-COVID to wave 2. There were very minor changes in mild-extreme problems in self-care (decrement=1.3%), pain/discomfort (decrement=2.6%), and anxiety/depression (decrement=0.9%). In the PC sample, there were increases of 4.8% in mild-extreme pain/discomfort and 10.7% in anxiety/depression from pre-COVID to wave 2. Despite these changes, HRQL of both samples pre-COVID and during waves 1 and 2 was worse than that of the general Alberta population. There were no significant variations in the impact of COVID-19 pandemic on HRQL across age, sex, and income subgroups in the ED survey; however, such variations were observed in the PC survey whereby younger adults, females, and those with high income had the largest HRQL deteriorations. CONCLUSION: The impact of COVID-19 pandemic on HRQL was minimal in adults seeking ED care, but more pronounced in those seen in PC, especially in terms of mental health. Policies around COVID-19 should take into account the needs of certain groups of the population, especially women and young people.
RéSUMé: OBJECTIFS: Examiner l'impact de la pandémie de COVID-19 sur la qualité de vie liée à la santé (QVLS) des adultes visitant les services d'urgence (SU) et les établissements de soins primaires (SP) en Alberta, au Canada, et déterminer si cet impact varie selon les sous-groupes démographiques. MéTHODES: Les données de deux enquêtes transversales répétées qui ont mesuré la QVL à l'aide de l'EQ-5D-5L ont été utilisées; « pré-COVID ¼ septembre 2019-février 2020 (SU, N=5 927; SP, N=317), « Vague-1 ¼ mars 2020-août 2020 (SU, N=4 781; SP, N=375) et « Vague-2 ¼ septembre 2020-janvier 2021 (SU, N=4 443; SP, N=327). RéSULTATS: Dans l'échantillon du SU, il y a eu des diminutions des problèmes légers à extrêmes de 3,7 % dans la mobilité et de 4,1 % dans les activités habituelles de la période pré-COVID à la vague 2. Il y a eu des changements très mineurs dans les problèmes légers à extrêmes dans les soins personnels (diminution = 1,3 %), douleur/gêne (diminution=2,6 %) et anxiété/dépression (diminution=0,9 %). Dans l'échantillon SP, il y a eu des augmentations de 4,8 % de la douleur/gêne légère à extrême et de 10,7 % de l'anxiété/de la dépression de la période pré-COVID à la vague 2. Malgré ces changements, la QVLS des deux échantillons avant la COVID et pendant les vagues 1 et 2 était pire que celle de la population générale de l'Alberta. Il n'y avait pas de variations significatives de l'impact de la pandémie de COVID-19 sur la QVLS selon l'âge, le sexe et les sous-groupes de revenu dans l'enquête SU; cependant, de telles variations ont été observées dans l'enquête SP, où les jeunes adultes, les femmes et les personnes à revenu élevé présentaient les plus fortes détériorations de la QVLS. CONCLUSION: L'impact de la pandémie de COVID-19 sur la QVLS était minime chez les adultes cherchant des SU, mais plus prononcé chez ceux observés dans le SP, en particulier en termes de santé mentale. Les politiques autour de COVID-19 devraient prendre en compte les besoins de certains groupes de la population, en particulier les femmes et les jeunes.