Health-related quality of life among multiethnic public polyclinic users in Singapore and associated factors: a cross-sectional study.

Abstract

Purpose: Health-related quality of life (HRQoL) is a crucial health outcome, reflecting both clinical status and broader well-being. Singapore faces the dual challenge of rapid population ageing and increasing chronic disease prevalence. Yet, comprehensive data on HRQoL in primary care remain scarce, as most research focuses on hospital-based or disease-specific populations rather than routine public primary care (polyclinic) users. This study aimed to describe HRQoL among public polyclinic users in Singapore and identify sociodemographic, clinical, and patient activation factors associated with HRQoL variations.

Methods: We conducted a cross-sectional study among adults attending two large public polyclinics in Singapore. Participants completed the EQ-5D-5L, the Consumer Health Activation Index (CHAI), and surveys on sociodemographic and clinical characteristics. We summarised HRQoL and participant characteristics descriptively and used a two-part regression model for the EQ-5D-5L index and linear regression for the EQ VAS scores to identify independent predictors.

Results: Among the 572 participants, the mean EQ index and EQ VAS scores were 0.89 (SD = 0.16) and 77.0 (SD = 12.7), respectively. Pain/Discomfort and Anxiety/Depression were the dimensions with the most reported problems (23.1% and 18.4%, respectively). Higher CHAI scores (EQ index: β = 0.002; VAS: β = 5.0) and better self-rated health (EQ index: β = 0.09; VAS: β = 14.3) predicted better HRQoL. Malay ethnicity and comorbidities were linked to lower EQ index scores, while younger age, male gender, and moderate income were associated with lower EQ VAS scores.

Conclusions: HRQoL among Singaporean polyclinic users varies by sociodemographic, clinical, and activation factors, underscoring persistent age, ethnic, and gender disparities. Integrating HRQoL assessment and culturally tailored interventions into primary care may help reduce these inequities.