Association between multimorbidity patterns and catastrophic health expenditure among Chinese older adults living alone

Zhai, Xinjia; Zhang, Quan; Li, Xinxuan; Zhao, Xiaoke

doi:10.1016/j.archger.2022.104892

Cited by 10 publications

(5 citation statements)

References 42 publications

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“…[ 50 ] The spine group was dominated by intervertebral disc disease, which is the primary cause of the decrease or loss of labor ability, [ 51 ] particularly in middle-aged people. Although no studies directly support our results, a relevant study indicates that multisystem and cardiovascular diseases significantly increase catastrophic health expenditure, [ 27 ] and the multisystem morbidity group has the highest self-treatment cost. [ 5 ]…”

Section: Discussionmentioning

confidence: 61%

“…[ 13 ] The high prevalence of hypertension [ 47 ] and diabetes [ 48 ] and the required long-term medication [ 49 ] have increased HPV. Cardiovascular diseases have a significantly high incidence and intensity of catastrophic health expenditure [ 27 ] and are considered major contributors to the global economic burden of chronic conditions. [ 50 ] The spine group was dominated by intervertebral disc disease, which is the primary cause of the decrease or loss of labor ability, [ 51 ] particularly in middle-aged people.…”

Section: Discussionmentioning

confidence: 99%

“…Economic burden, [ 25 ] healthcare utilization, [ 26 ] and catastrophic medical expenditure [ 27 ] result from different multimorbidity patterns. Furthermore, a study [ 28 ] showed that HPV caused by different chronic diseases vary.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between the health poverty vulnerability and multimorbidity patterns identified with latent class analysis aged 45 years or more adults in Northwestern China: A cross-section study

Du,

Guo,

Wang

et al. 2024

Medicine

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This study aims to identify multimorbidity patterns and examine whether health poverty vulnerability (HPV) varies among adults aged 45 years or more. Data from 4338 participants were extracted from a Chinese cross-sectional study. Latent class analysis was used to identify multimorbidity patterns based on 11 self-reported chronic diseases. A 3-stage feasible generalized least-squares method was used to measure the HPV. The associations and influencing factors were analyzed using the Tobit model. The mean HPV values were 0.105 ± 0.225 and 0.329 ± 0.357, based on extreme poverty and those of low- and middle-income countries’ poverty line, respectively. Four latent multimorbidity patterns were identified, comprising hypertension (57.33%), cardiovascular diseases (19.94%), the musculoskeletal system (13.09%), and spine (9.64%). The HPV value from hypertension (coefficient [Coef] =0.03, 95% confidence interval (CI) = 0.00–0.05) was significantly higher than that of the musculoskeletal system based on extreme poverty. In addition, the HPV values for hypertension (Coef =0.08, 95% CI = 0.05–0.11), spine (Coef =0.06, 95% CI = 0.02–0.11), and cardiovascular diseases (Coef =0.07, 95% CI = 0.03–0.11) were significantly high based on low- and middle-income countries’ poverty line. Age ≥75 years, registered poor households, catastrophic medical expenditure, and toilet style were major risk factors. Although the multimorbidity pattern-induced HPV has been significant improved on extreme poverty, it still poses a very serious challenge with regard to low- to middle-income countries’ poverty line. The sensitivity analysis proved the robustness of the results. Policymakers should focus on adults with 3 multimorbidity patterns, namely, registered poor households, age ≥75 years, and catastrophic health expenditure, to adopt targeted interventions to prevent and eliminate HPV.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between the health poverty vulnerability and multimorbidity patterns identified with latent class analysis aged 45 years or more adults in Northwestern China: A cross-section study

Du,

Guo,

Wang

et al. 2024

Medicine

View full text Add to dashboard Cite

show abstract

“…30 Different multimorbidity patterns have been found to have different effects on self-rated health, catastrophic health expenditures, risk of frailty, and 5-year mortality in older adults. [31][32][33][34] In this study, multimorbidity was divided into three patterns: relatively healthy pattern, respiratory pattern, and cardiovascular pattern.…”

Section: Discussionmentioning

confidence: 99%

Association of multimorbidity patterns with motoric cognitive risk syndrome among older adults: Evidence from a China longitudinal study

Xiong,

Wang,

Zhu

et al. 2023

Int J Geriat Psychiatry

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ObjectivesMotoric cognitive risk syndrome (MCR), a pre‐dementia syndrome, is characterized by slow gait and subjective cognitive complaints among older adults. This study assessed the relationship between multimorbidity, its patterns, and MCR.MethodsData for this study were obtained from three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study. Participants who were aged 60 years and older and had complete data at baseline as well as complete data about MCR at follow‐up were selected. Patients without MCR at baseline were selected for further analyses. Longitudinal associations between multimorbidity, its patterns, and MCR were examined using a Cox proportional hazards model. Multimorbidity patterns were classified using latent class analysis.ResultsA total of 4923 respondents were included at baseline, 43.47% of whom had multimorbidity. Additionally, the prevalence of MCR at baseline was 12.61%. After adjusting for covariates, multimorbidity was positively associated with MCR (hazard ratio [HR] = 1.33, 95% confidence interval [CI] = 1.06–1.68). A higher number of multimorbidity was also significantly associated with an increased risk of developing MCR (HR = 1.10, 95% CI = 1.02–1.19). Three multimorbidity patterns were selected: relatively healthy pattern, respiratory pattern, and cardiovascular pattern. Older adults with the cardiovascular pattern were 1.57 times more likely to develop MCR than those with the relatively healthy pattern (HR = 1.57, 95% CI = 1.16–2.13). There was no significant difference between the relatively healthy pattern and the respiratory pattern (HR = 1.31, 95% CI = 0.91–1.92).ConclusionsMCR is highly prevalent among older Chinese adults. MCR may be exacerbated by multimorbidity. For older adults with multimorbidity (especially cardiovascular multimorbidity), attention should be paid to MCR to achieve early detection, diagnosis, and treatment.

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“…First, it focuses on double diseases, which encompass the presence of both communicable and noncommunicable diseases. In contrast, previous research has typically measured multimorbidity based on the presence of one or more communicable diseases or noncommunicable diseases [ 11 , 12 , 24 ]. Second, unlike previous studies that analyzed the effect of multimorbidity on outcome variables using average household out-of-pocket expenditure or population data, this research employs a quantile regression approach to examine the distribution of OOP expenditure associated with double diseases [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Out-of-pocket expenditures associated with double disease burden in Pakistan: a quantile regression analysis

Naz,

Sriram

2024

BMC Public Health

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Background Pakistan is currently experiencing a double burden of disease. Families with members having both communicable and noncommunicable diseases are at a greater risk of impoverishment due to enormous out-of-pocket payments. This study examines the percentile distribution of the determinants of the out-of-pocket expenditure on the double disease burden. Method The study extracted a sample of 6,775 households with at least one member experiencing both communicable and noncommunicable diseases from the Household Integrated Economic Survey 2018-19. The dataset is cross-sectional and nationally representative. Quantile regression was used to analyze the association of various socioeconomic factors with the OOP expenditure associated with double disease burden. Results Overall, 28.5% of households had double disease in 2018-19. The households with uneducated heads, male heads, outpatient healthcare, patients availing public sector healthcare services, and rural and older members showed a significant association with the prevalence of double disease. The out-of-pocket expenditure was higher for depression, liver and kidney disease, hepatitis, and pneumonia in the upper percentiles. The quantile regression results showed that an increased number of communicable and noncommunicable diseases was associated with higher monthly OOP expenditure in the lower percentiles (10th percentile, coefficient 312, 95% CI: 92–532), and OOP expenditure was less pronounced among the higher percentiles (75th percentile, coefficient 155, 95% CI: 30–270). The households with older members were associated with higher OOP expenditure at higher tails (50th and 75th percentiles) compared to lower (10th and 25th percentiles). Family size was associated with higher OOPE at lower percentiles than higher ones. Conclusion The coexistence of communicable and noncommunicable diseases is associated with excessive private healthcare costs in Pakistan. The results call for addressing the variations in financial costs associated with double diseases.

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Association between multimorbidity patterns and catastrophic health expenditure among Chinese older adults living alone

Cited by 10 publications

References 42 publications

Relationship between the health poverty vulnerability and multimorbidity patterns identified with latent class analysis aged 45 years or more adults in Northwestern China: A cross-section study

Relationship between the health poverty vulnerability and multimorbidity patterns identified with latent class analysis aged 45 years or more adults in Northwestern China: A cross-section study

Association of multimorbidity patterns with motoric cognitive risk syndrome among older adults: Evidence from a China longitudinal study

Out-of-pocket expenditures associated with double disease burden in Pakistan: a quantile regression analysis

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