Institute for Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Institute for Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada.
Am J Prev Med. 2018 Aug;55(2):142-150. doi: 10.1016/j.amepre.2018.04.004. Epub 2018 May 18.
Studies have highlighted the importance of life satisfaction or, more generally, happiness, on health. However, there are few studies that have prospectively assessed the relationship between life satisfaction and healthcare utilization and costs.
Participants were from three national survey cycles conducted between 2005 and 2010 to future healthcare utilization up to 2015. Analysis was conducted in 2016-2017. Annual per person costs were calculated and individuals ranked. Adjusted multinomial logistic regression models were used to quantify the association between life satisfaction and being in the top 5% or top 6%-50%, compared to the bottom 50%, during follow-up.
After exclusions, the study population included 85,225 adults. Increasing life dissatisfaction was associated with higher healthcare utilization and costs. In the fully adjusted model, the odds for those with the lowest level of life satisfaction being in the top 5% of healthcare costs relative to the lowest 50% is 3.05 (95% CI=1.61, 5.80). Those with the lowest life satisfaction were also at increased odds of being in the middle utilization category (6%-50%) with a significant OR=2.24 (95% CI=1.60, 3.14). All trends for increasing dissatisfaction were significant (p<0.001).
Life dissatisfaction was significantly associated with being a high-cost user in the future. This relationship persisted after adjustment for demographic factors, comorbidity, socioeconomic factors, and health behaviors. This study points to the importance of considering broader correlates of well-being with respect to future healthcare utilization and costs.
研究强调了生活满意度或更普遍的幸福感对健康的重要性。然而，很少有研究前瞻性评估生活满意度与医疗保健利用和成本之间的关系。
参与者来自于 2005 年至 2010 年期间进行的三个全国性调查周期，以预测未来至 2015 年的医疗保健利用情况。分析于 2016-2017 年进行。计算了人均年度费用并进行了排名。使用调整后的多项逻辑回归模型来量化生活满意度与在随访期间处于前 5%或前 6%-50%与后 50%之间的关系。
排除后，研究人群包括 85225 名成年人。生活满意度的增加与更高的医疗保健利用和成本相关。在完全调整的模型中，生活满意度最低的人在医疗保健费用中处于前 5%的几率为最高 50%的 3.05 倍（95%CI=1.61, 5.80）。生活满意度最低的人也有更高的可能性处于中等利用类别（6%-50%），具有显著的 OR=2.24（95%CI=1.60, 3.14）。所有不满情绪增加的趋势均具有统计学意义（p<0.001）。
生活不满与未来成为高成本使用者显著相关。这种关系在调整人口统计学因素、合并症、社会经济因素和健康行为后仍然存在。这项研究表明，考虑更广泛的幸福感相关性对于未来的医疗保健利用和成本非常重要。
