School of Public Health, Shandong University, Jinan, 250012, China.
NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
Aging Clin Exp Res. 2020 Oct;32(10):1985-1991. doi: 10.1007/s40520-019-01410-4. Epub 2019 Nov 19.
Frailty is a public health concern in the ageing population. Little is known about the role of gender in the relationship between frailty and health care utilization in older adults.
The study aims to examine gender differences in the association between different frailty status and health care utilization among Chinese older people.
A total of 7070 older adults (60+) from Shandong Province, China, were enrolled in this study. Frailty was assessed by frailty index constructed using 45 health deficits. Multivariate logistic regression models were employed separately for men and women to examine the impact of frailty on self-care, outpatient, and inpatient utilization.
Overall, the prevalence of frailty was 7.9% in older adults, with 7.1% and 8.3% in men and women, respectively. 49.4% respondents reported they had self-care in the previous 2 weeks, and women were more likely to have self-care than men. Being pre-frail and frail was significantly associated with utilization of all types of health care among older men and women, and the relationship was stronger in the frail groups than that in the pre-frail groups except for self-care. Respective odds ratios for outpatient utilization were higher in men than that in women.
Frailty is a frequent condition in Chinese older adults. The association between frailty and health care utilization (except outpatient) tended to be stronger in women than men. The gender differences should be considered when designing the preventing or delaying the installation of frailty and geriatric care plans.
衰弱是老龄化人口中的一个公共卫生问题。关于性别在老年人衰弱与医疗保健利用之间的关系中的作用知之甚少。
本研究旨在探讨不同衰弱状态与中国老年人医疗保健利用之间的关系中性别差异。
本研究共纳入来自中国山东省的 7070 名 60 岁以上老年人。采用 45 项健康缺陷构建衰弱指数评估衰弱情况。分别对男性和女性使用多变量逻辑回归模型，以检验衰弱对自我护理、门诊和住院利用的影响。
总体而言，老年人的衰弱患病率为 7.9%，男性和女性分别为 7.1%和 8.3%。49.4%的受访者报告在过去 2 周内进行过自我护理，女性比男性更有可能进行自我护理。衰弱前期和衰弱与所有类型的医疗保健利用均显著相关，在衰弱组中的相关性强于衰弱前期组，除自我护理外。男性门诊利用率的相应优势比高于女性。
衰弱在中国老年人中较为常见。衰弱与医疗保健利用（除门诊外）之间的关联在女性中比男性更强。在制定预防或延缓衰弱和老年护理计划时，应考虑到这些性别差异。
