Zhongguo quanke yixue (Apr 2024)
Health-related Quality of Life and Its Influencing Factors among Elderly Patients with Multimorbidity in China
Abstract
Background With the population aging, the prevalence of chronic diseases in China is increasing annually, contributing to a growing incidence of multimorbidity. Research on quality of life focuses mostly on specific diseases, such as diabetes, hypertension, and cardiovascular diseases. However, there are relatively few studies on the quality of life of multimorbidity. Objective To understand the status and influencing factors of the health-related quality of life (HRQoL) among elderly patients with multimorbidity, so as to provide a basis for improving their health level. Methods A total of 3 361 patients with multimorbidity aged ≥55 years and with complete values of key variables were selected as the study subjects by using the China Health and Retirement Longitudinal Study (CHARLS) 2018 data. The EQ-5D-3L was used to assess the HRQoL. The Age-adjusted Charlson Comorbidity Index (ACCI) was used to calculate the ten-year survival. Mann-Whitney or Kruskal-Wallis tests and the Tobit regression model were employed to explore factors influencing the HRQoL. Results The health utility value for elderly patients with multimorbidity was 0.888 (0.709, 0.964), the dimension with the highest proportion of "difficulty" was pain/discomfort [2 430 (72.30%) ], the dimension with the highest percentage of "severe difficulty" was mobility [593 (17.64%) ]. The highest ten-year survival rate was 90.15%, which was achieved by only 2.44% (82/3 361) of patients; the majority of patients [848 (25.23%) ] had a ten-year survival rate of 21.36%, and 43.59% (1 465/3 361) had a ten-year survival rate close to zero. The Tobit regression results showed that primary school degree or above and non-smoking behavior were protective factors for HRQoL; while female, aged over 60 years, widowhood, self-rated health status as poor, non-drinking behavior, insufficient or excessive sleep duration, no moderate-intensity activity, four or more chronic diseases, and more than three outpatient visits were risk factors for HRQoL (P<0.05) . Conclusion The HRQoL among Chinese elderly patients with multimorbidity was relatively poor, and factors such as marital status, educational level, sleep duration, physical activity, number of chronic diseases deserve to be focused on. Healthy lifestyle guidance for elderly patients with multimorbidity should be strengthened to further improve the quality of life of this population.
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