Zhongguo quanke yixue (Jul 2022)
Effects of Chronic Diseases on Quality Adjusted Life Year and Economic Losses of the Elderly
Abstract
Background Chronic diseases have become an important public health problem that affects the economic and social development of country and population health. Quantifying the disease and economic burden of the elderly can provide a better understanding of the impact of chronic diseases on individuals and society. Objective To understand the prevalence of common chronic diseases among the elderly in Shanxi Province and explore the quality-adjusted life year (QALY) loss and economic loss which caused by chronic diseases. Methods From June to August in 2019, a multi-stage random sampling method was used to select 3 250 elderly people aged≥ 60 years from 11 cities in Shanxi Province as the research subjects for a questionnaire survey. The questionnaire included general demographic information, disease status survey, and health-related quality of life status. The European Five-Dimensional Health Scale (EQ-5D-5L) was used to assess the health-related life quality of the elderly. The QALY loss caused by chronic diseases was calculated based on the Chinese EQ-5D-5L utility value score system, and the QALY loss and economic loss caused by common chronic diseases in Shanxi Province in 2019 were estimated by using population and GDP per capita from statistical bulletin. Results The results of univariate analysis showed that there were significant differences in the utility value of EQ-5D-5L among the elderly with different ages, living regions, educational levels, marital status, and family per capita monthly income (P<0.05) . The results of multiple linear regression analysis showed that higher per capita monthly income of families, being married and younger age were the protective factors for the health utility value of EQ-5D-5L (P<0.05) . The prevalence of chronic diseases among the elderly in Shanxi Province was 58.49% (1 901/3 250) . The top 5 chronic diseases by prevalence were: hypertension 29.45% (957/3 250) , diabetes 10.83% (352/3 250) , rheumatism or rheumatoid arthritis 10.28% (334/3 250) , hearing impairment 8.09% (263/3 250) , gastritis or peptic ulcer 6.49% (211/3 250) . Based on the estimation of the total population of Shanxi Province, the loss of QALY caused by five common chronic diseases in Shanxi Province in 2019 was 2 078 685 years, and the economic loss was 95 045 792 940yuan. The chronic disease causing the most QALY loss and economic loss in Shanxi Province was rheumatism or rheumatoid arthritis in Datong, Taiyuan and Luliang; in Jincheng, Yangquan city was hearing impairment; In Jinzhong, Linfen, Yuncheng, Shuozhou, Xinzhou, Changzhi City was hypertension. Conclusion The prevalence of chronic diseases among the elderly in Shanxi Province was relatively high, and chronic diseases will not only cause the loss of QALY of the elderly, but also cause a huge economic burden. Common chronic diseases vary by region in Shanxi Province, each region should determine the priority of disease prevention and treatment according to the actual situation, identify the key objectives and population of health management, so as to achieve a multiplier effect.
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