Abstract
Objectives
China has the world's largest aging population, of which 46% have multimorbidity and
38% have functional impairment. Older adults with multimorbidity often suffer functional
impairment as well; however, it is not clear how current health care services have
been used in this population. This study aimed to compare health care utilization
among Chinese older adults at different levels of chronic disease and functional impairment.
Design
A cross-sectional design. Multivariate 2-part models were used to examine the probability
and frequency of health care utilization.
Setting and Participants
Data were from 5166 adults aged 65 or older from the 2015 wave of the China Health
and Retirement Longitudinal Study. The sample included 22% without any chronic condition,
27% with 1 chronic condition, 44% with multimorbidity, and 7% with multimorbidity
and functional impairment.
Measures
Health care utilization included outpatient visits, inpatient visits, and unmet hospitalization
needs.
Results
As the number of chronic conditions and functional impairments increased, older adults
tend to access health care more. Older adults with both multimorbidity and functional
impairment tend to use health care services most, but still reported the highest level
of unmet hospitalization needs among all groups.
Conclusions and Implications
Chinese older adults with multimorbidity and functional impairment may have experienced
multiple barriers in accessing health care. Social programs should be created to make
health care more accessible among older adults. The health care delivery system could
be oriented to home-based medical care, which have been found effective in delivering
high-quality care and reducing health care costs.
Keywords
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Article info
Publication history
Published online: March 25, 2020
Footnotes
C.L. and R.Z. contributed equally to this work.
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
