Implications of multimorbidity on healthcare utilisation and work productivity by socioeconomic groups: Cross-sectional analyses of Australia and Japan

Sum, Grace; Ishida, Marie; Koh, Gerald Choon‐Huat; Singh, Ankur; Oldenburg, Brian; Lee, John Tayu

doi:10.1371/journal.pone.0232281

Cited by 20 publications

(17 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One signi cant observation is that our sample is slightly older compared to other middle-aged primary care populations, 3,15,24 with most of our patients aged between 55 -64 years old. This is re ective of the middle-age distribution at our centre as well as the fast-ageing Singapore population.…”

Section: Discussionmentioning

confidence: 81%

How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

Sim¹,

Koh²,

Lee³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Multimorbidity is of increasing prevalence and importance. It has been negatively associated with health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity for the middle-aged population, defined as those between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore.Methods: A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses.Results: The study included 297 participants, aged 40-64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient -0.064 (C.I -0.125, -0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient -0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort.Conclusion: Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.

show abstract

Section: Discussionmentioning

confidence: 81%

How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

Sim¹,

Koh²,

Lee³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…One significant observation is that our sample is slightly older compared to other middle-aged primary care populations, [ 3 , 15 , 24 ] with most of our patients aged between 55 and 64 years old. This is reflective of the middle-age distribution at our centre as well as the fast-ageing Singaporean population [ 22 ] Within our study population participants below 50 years of age had poorer HrQoL compared to those aged 60 years and above, a finding similar to that by Peters et al [ 47 ] Possible explanations include the burden of additional responsibilities such as work or caring for children and elderly parents, and the higher likelihood of younger people reporting mental health problems which may have affected the EQ5D UI [ 47 ].…”

Section: Discussionmentioning

confidence: 83%

“…People with multimorbidity have poorer HrQoL, [ 9 – 11 ] higher healthcare costs and utilization, [ 12 , 13 ] higher mortality, [ 14 ] and reduced work productivity and working performance [ 15 ]. However, the impact of multimorbidity may be different across various age groups.…”

Section: Introductionmentioning

confidence: 99%

How does multimorbidity affect middle-aged adults? A cross-sectional survey in the Singapore primary healthcare setting

Sim¹,

Koh²,

Lee³

et al. 2020

BMC Fam Pract

View full text Add to dashboard Cite

Background Multimorbidity is of increasing prevalence and importance. It has been associated with poorer health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity in the middle-aged population, defined as those aged between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore. Methods A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses. Results The study included 297 participants, aged 40–64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient − 0.064 (C.I -0.125, − 0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient − 0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort. Conclusion Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.

show abstract

“…Due to the urban-rural dual structure in China, there are signi cant differences between urban and rural areas in the supply of healthcare services and the economic income of the older adults [35], and there are also signi cant differences in the in uence of supply-side and demand factors on the utilization of healthcare services for the older adults in urban and rural areas [36]. In general, urban older adults are more inclined to use healthcare services due to their higher economic level, education level, and better healthcare insurance [37].…”

Section: Analysis Frameworkmentioning

confidence: 99%

A New Perspective of Urban-rural Differences: the Impact of Supply and Demand on Healthcare Services for the Older Adults: a Case Study of Shaanxi Province

Zhang¹,

Niu²,

Zhang³

2021

Preprint

View full text Add to dashboard Cite

Background: With the rapidly aging of Chinese society and the change of Chinese residents’ disease spectrum, the older adults utilization of the healthcare services surges as well. Studies on factors that potentially influence the utilization of healthcare services for the older adults becomes increasing important, which could benefit improving the service effect and the quality of life of the older adults in later life. This article compares and analyzes the differences in the using of healthcare services by the older adults in urban and rural areas based on the supply and demand of healthcare services for the older adults and analyzes the reasons for potential differences. Methods: Using data from a survey conducted in three cities in Shaanxi Province in 2019. All authors participated in the questionnaire survey. We obtained a total of 948 questionnaires. Multivariate regression model and Oaxaca-Blinder decomposition model are used to analyze the difference between the supply and demand of medical services for the older adults in urban and rural areas.Results: The results find that age, household register, living activities of daily living (ADL), (P<0.01) and healthcare treatment insurance significantly impact the older adults use of healthcare services. Meanwhile, factors from the supply and demand factors have a significant correlation with the utilization of services for the older adults, including the healthcare service quality(P<0.01), the diversity of service content(P<0.01), the rationality of service charge(P<0.01), service satisfaction(P<0.01), family support (P<0.1) level and the main illness(P<0.05). Moreover, the results show a significant difference in the use of healthcare services for the older adults between urban and rural areas. Specifically, in urban areas, the influences of service quality, the diversity of service content and the rationality of service from the supply have a significant correlation with the utilization of services for the older adults. The service satisfaction, service demand and family support in the demand factors have a significant correlation with the utilization of services for the older adults. In comparisons, for the older adults in rural areas, the diversity of service content from the supply factors as well as economic level and main illness from the demand factors have a significant correlation with the utilization of services for the older adults.Conclusions: From the perspective of supply and demand, this paper constructs an analytical framework of the determinants of healthcare services for the older adults from a new perspective. Based on the analysis framework and from the perspective of supply and demand of healthcare services utilization, the differences between urban and rural areas in the utilization of medical care for the older adults and the influencing factors are studied. It provides a new research perspective to explore the influencing factors of healthcare services utilization for the older adults. Supply factors and demand factors have a significant correlation with the utilization of healthcare services for the older adults. There are also significant differences in the factors influencing the utilization of health services by urban and rural older adults. When strengthening and improving the supply of healthcare services for the older adults, the previous thinking of “top-down” and “service-centered” should be changed, and gradually transformed into “bottom-up” and “demand-centered”.

show abstract

Implications of multimorbidity on healthcare utilisation and work productivity by socioeconomic groups: Cross-sectional analyses of Australia and Japan

Cited by 20 publications

References 56 publications

How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

How does multimorbidity affect middle-aged adults? A cross-sectional survey in the Singapore primary healthcare setting

A New Perspective of Urban-rural Differences: the Impact of Supply and Demand on Healthcare Services for the Older Adults: a Case Study of Shaanxi Province

Contact Info

Product

Resources

About