The impact of influenza on the health related quality of life in China: an EQ-5D survey

BACKGROUND Influenza causes considerable morbidity and mortality in China, but its impact on the health-related quality of life (HRQoL) has not been previously measured. METHODS We conducted a retrospective telephone survey to assess the impact of influenza on the HRQoL among outpatients and inpatients using the EuroQoL EQ-5D-3 L instrument. Participants were individuals with laboratory-confirmed influenza infection registered by the National Influenza-like-illness Surveillance Network in 2013. RESULTS We interviewed 839 of 11,098 eligible influenza patients. After excluding those who were unable to complete the HRQoL for the registered influenza episode, 778 patients were included in the analysis. Both outpatients (n = 529) and inpatients (n = 249) most commonly reported problems with pain/discomfort (71.8% of outpatients and 71.9% of inpatients) and anxiety/depression (62.0% of outpatients and 75.1% of inpatients). For individual influenza outpatients, the mean health utility was 0.6142 (SD 0.2006), and the average quality adjusted life days (QALD) loss was 1.62 (SD 1.84) days. The HRQoL of influenza inpatients was worse (mean health utility 0.5851, SD 0.2197; mean QALD loss 3.51 days, SD 4.25) than that of outpatients (p < 0.05). The presence of underlying medical conditions lowered the HRQoL for both outpatients and inpatients (p < 0.05). CONCLUSIONS Influenza illness had a substantial impact on HRQoL. QALD loss due to an acute influenza episode in younger children was comparable to that due to enterovirus A71-associated hand, foot and mouth disease. Our findings are key inputs into disease burden estimates and cost-effectiveness evaluations of influenza-related interventions in China.