Health-Related Quality of Life and Health Service Use among Multimorbid Middle-Aged and Older-Aged Adults in China: A Cross-Sectional Study in Shandong Province



Zhao, Qinfeng, Wang, Jian, Nicholas, Stephen, Maitland, Elizabeth ORCID: 0000-0003-1551-4787, Sun, Jingjie, Jiao, Chen, Xu, Lizheng and Leng, Anli
(2020) Health-Related Quality of Life and Health Service Use among Multimorbid Middle-Aged and Older-Aged Adults in China: A Cross-Sectional Study in Shandong Province. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 17 (24). E9261-.

[img] Text
Health-Related Quality of Life and Health Service Use among Multimorbid Middle-Aged and Older-Aged Adults in China A Cross-S.pdf - Published version

Download (564kB) | Preview

Abstract

(1) Background: The management of multiple chronic diseases challenges China's health system, but current research has neglected how multimorbidity is associated with poor health-related quality of life (HRQOL) and high health service demands by middle-aged and older adults. (2) Methods: A cross-sectional study was conducted in Shandong province, China in 2018 across three age groups: Middle-aged (45 to 59 years), young-old (60 to 74 years), and old-old (75 or above years). The information about socio-economic, health-related behaviors, HRQOL, and health service utilization was collected via face-to-face structured questionnaires. The EQ-5D-3L instrument, comprising a health description system and a visual analog scale (VAS), was used to measure participants' HRQOL, and χ<sup>2</sup> tests and the one-way ANOVA test were used to analyze differences in socio-demographic factors and HRQOL among the different age groups. Logistic regression models estimated the associations between lifestyle factors, health service utilization, and multimorbidity across age groups. (3) Results: There were 17,867 adults aged 45 or above in our sample, with 9259 (51.82%) female and 65.60% living in rural areas. Compared with the middle-aged adults, the young-old and old-old were more likely to be single and to have a lower level of education and income, with the old-old having lower levels than the young-old (<i>P</i> < 0.001). We found that 2465 (13.80%) suffered multimorbidities of whom 75.21% were older persons (aged 60 or above). As age increased, both the mean values of EQ-5D utility and the VAS scale decreased, displaying an inverse trend to the increase in the number of chronic diseases (<i>P</i> < 0.05). Ex-smokers and physical check-ups for middle or young-old respondents and overweight/obesity for all participants (<i>P</i> < 0.05) were positively correlated with multimorbidity. Drinking within the past month for all participants (<i>P</i> < 0.001), and daily tooth-brushing for middle (<i>P</i> < 0.05) and young-old participants (<i>P</i> < 0.001), were negatively associated with multimorbidity. Multimorbidities increased service utilization including outpatient and inpatient visits and taking self-medicine; and the probability of health utilization was the lowest for the old-old multimorbid patients (<i>P</i> < 0.001). (4) Conclusions: The prevalence and decline in HRQOL of multimorbid middle-aged and older-aged people were severe in Shandong province. Old patients also faced limited access to health services. We recommend early prevention and intervention to address the prevalence of middle-aged and old-aged multimorbidity. Further, the government should set-up special treatment channels for multiple chronic disease sufferers, improve medical insurance policies for the older-aged groups, and set-up multiple chronic disease insurance to effectively alleviate the costs of medical utilization caused by economic pressure for outpatients and inpatients with chronic diseases.

Item Type: Article
Uncontrolled Keywords: China, multimorbidity, middle-aged and old-aged adults
Divisions: Faculty of Humanities and Social Sciences > School of Management
Depositing User: Symplectic Admin
Date Deposited: 10 Aug 2021 14:52
Last Modified: 03 Feb 2024 08:44
DOI: 10.3390/ijerph17249261
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3133037