Abstract
Abstract
Background
Previous studies have indicated that older adults with multimorbidity had higher risk of incurring catastrophic health expenditure (CHE). However, the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity remains unclear. This study aims to explore the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity, and whether this effect is moderated by economic status.
Methods
A cross-sectional household survey of the older adults in 2019 in Shandong province, China. A total of 606 single empty-nest elderly aged 60 years or older were included in this study. CHE was defined as the out-of-pocket payments for health care that equals or exceeds 40% of the household’ s capacity to pay. Logistic regression models are employed to examine the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity. The interaction term is introduced to explore the economic status difference in this effect.
Results
The CHE incidence for single empty-nest elderly with multimorbidity alone is 64.2%, and the co-occurrence of frailty results in an increase by almost 1.3 times (84.0%) in CHE incidence among single empty-nest elderly with multimorbidity. The co-occurrence of frailty increases the risk of incurring CHE among the single empty-nest elderly with multimorbidity, with the odds of incurring CHE increased by 3.19 times (OR = 3.19; P = 0.005). Furthermore, the interaction analysis shows that the effect of co-occurrence of frailty on CHE among single empty-nest elderly with multimorbidity still exist in lower economic status groups (OR = 4.64; P = 0.027), but not in higher economic status (OR = 2.76; P = 0.062).
Conclusions
This study demonstrates that there is a positive effect of co-occurrence of frailty on the CHE among the single empty-nest elderly with multimorbidity, and this effect varies by economic status. The health policy-makers should reorganize the healthcare system to make it pro-poor, so as to meet the multiple medical demand and reduce the potential economic burden and inequalities of older adults.
Funder
National Natural Science Foundation of China
China Medical Board
Cheeloo Youth Scholar Grant
Shandong University
NHC Key Laboratory of Health Economics and Policy Research
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Policy
Reference40 articles.
1. The United Nations. World Population Ageing 2019: Highlights; 2019.
2. Chen Y, Hicks A, While AE. Quality of life and related factors: a questionnaire survey of older people living alone in mainland China. Qual Life Res. 2014;23(5):1593–602.
3. Zhang C, Xue Y, Zhao H, Zheng X, Zhu R, Du Y, et al. Prevalence and related influencing factors of depressive symptoms among empty-nest elderly in Shanxi, China. J Affect Disord. 2019;245:750–6.
4. Liu N, Zeng L, Li Z, Wang J. Health-related quality of life and long-term care needs among elderly individuals living alone: a cross-sectional study in rural areas of Shaanxi Province, China. BMC ePublic Health. 2013;13(1):313.
5. Mercer S, Furler J, Moffat K, Fischbacher-Smith D, Sanci L. Multimorbidity: technical series on safer primary care. Geneva: World Health Organization; 2016.
Cited by
19 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献