Author:
Chen Shu,Si Yafei,Hanewald Katja,Li Bingqin,Wu Chenkai,Xu Xiaolin,Bateman Hazel
Abstract
Abstract
Background
The impact of multimorbidity on long-term care (LTC) use is understudied, despite its well-documented negative effects on functional disabilities. The current study aims to assess the association between multimorbidity and informal LTC use in China. We also explored the socioeconomic and regional disparities.
Methods
The study included 10,831 community-dwelling respondents aged 45 years and older from the China Health and Retirement Longitudinal Study in 2011, 2015, and 2018 for analysis. We used a two-part model with random effects to estimate the association between multimorbidity and informal LTC use. Heterogeneity of the association by socioeconomic position (education and income) and region was explored via a subgroup analysis. We further converted the change of informal LTC hours associated with multimorbidity into monetary value and calculated the 95% uncertainty interval (UI).
Results
The reported prevalence of multimorbidity was 60·0% (95% CI: 58·9%, 61·2%) in 2018. We found multimorbidity was associated with an increased likelihood of receiving informal LTC (OR = 2·13; 95% CI: 1·97, 2·30) and more hours of informal LTC received (IRR = 1·20; 95% CI: 1·06, 1·37), ceteris paribus. Participants in the highest income quintile received more hours of informal LTC care (IRR = 1·62; 95% CI: 1·31, 1·99). The estimated monetary value of increased informal LTC hours among participants with multimorbidity was equivalent to 3·7% (95% UI: 2·2%, 5·4%) of China’s GDP in 2018.
Conclusion
Our findings substantiate the threat of multimorbidity to LTC burden. It is imperative to strengthen LTC services provision, especially among older adults with multimorbidity and ensure equal access among those with lower income.
Funder
University of New South Wales
ARC Centre of Excellence in Population Ageing Research
Publisher
Springer Science and Business Media LLC
Subject
Geriatrics and Gerontology
Reference54 articles.
1. Mercer S, Furler J, Moffat K, Fischbacher-Smith D, Sanci LA, World Health Organization. et al. Multimorbidity: Technical Series on Safer Primary Care. Geneva: World Health Organization; 2016.
2. Pearson-Stuttard J, Ezzati M, Gregg EW. Multimorbidity—a defining challenge for health systems. The Lancet Public Health. 2019;4(12):e599–600.
3. Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: a systematic review and meta-analysis of observational studies. J Comorb. 2019;9:2235042X1987093.
4. Dugravot A, Fayosse A, Dumurgier J, Bouillon K, Rayana TB, Schnitzler A, et al. Social inequalities in multimorbidity, frailty, disability, and transitions to mortality: a 24-year follow-up of the Whitehall II cohort study. The Lancet Public Health. 2020;5(1):e42–50.
5. Head A, Fleming K, Kypridemos C, Schofield P, Pearson-Stuttard J, O’Flaherty M. Inequalities in incident and prevalent multimorbidity in England, 2004–19: a population-based, descriptive study. The Lancet Healthy Longevity. 2021;2(8):e489–97.