近日，山东大学公共治理研究院冷安丽博士后作为通讯作者在医学学术期刊《International Journal of Environmental Research and Public Policy》上发表文章《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》（点击文章题目查看原文内容）。
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 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 ( < 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 ( < 0.05). Ex-smokers and physical check-ups for middle or young-old respondents and overweight/obesity for all participants ( < 0.05) were positively correlated with multimorbidity. Drinking within the past month for all participants ( < 0.001), and daily tooth-brushing for middle ( < 0.05) and young-old participants ( < 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 ( < 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.
China; multimorbidity; middle-aged and old-aged adults
冷安丽，山东大学政治学与公共管理学院博士后，主要研究方向为卫生经济学评价，行为与实验经济学。先后主持国家自然科学基金项目、国家自然科学基金委员会应用研究项目、挪威科研基金委员会资助项目的研究。在《Vaccine》《BMC Cancer》《Archives of Psychiatric Nursing》
《BMC Palliative Care》《社会学评论》《中国公共卫生》等发表SCI、CSSCI、CSCD 期刊论文数篇。
【文丨孙嘉翼 审核丨冷安丽 编辑丨孙嘉翼】