Health utility value and its influencing factors among adult residents in Zhejiang province: a cross-sectional study using Shapley value decomposition analysis

ObjectiveTo understand the health utility value and its influencing factors among adult residents in Zhejiang province, and to provide a reference for health policy formulation and evaluation. MethodsA face-to-face survey using a self-developed questionnaire was conducted from September 2022 to February 2023 among 9 000 adult residents (≥ 18 years) recruited using a multistage random sampling technique from 30 districts/counties in Zhejiang province. Participants' health utility values were calculated and adjusted using the compound hierarchical ordered probit model (CHOPIT). Multiple linear regression model and Shapley value decomposition method were used to analyze the effects and contributions of influencing factors on participants' health utility values. ResultsThe mean health utility value was 0.703 ± 0.158 for 8 684 successfully surveyed participants. The Shapley value decomposition analysis showed that the Shapley value was 0.277 for demographic characteristics, 0.106 for socioeconomic status, 0.042 fo