Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, People's Republic of China.
Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, Shaanxi, China.
Sci Rep. 2021 Apr 8;11(1):7776. doi: 10.1038/s41598-021-87444-z.
This study investigated associations between cardiometabolic diseases, frailty, and healthcare utilization and expenditure among Chinese older adults. The participants were 5204 community-dwelling adults aged at least 60 years from the China Health and Retirement Longitudinal Study. Five cardiometabolic diseases were assessed including hypertension, dyslipidemia, diabetes, cardiac diseases and stroke. Frailty status was based on five criteria: slowness, weakness, exhaustion, inactivity, and shrinking. Participants were deemed frailty if they met at least three criteria. As the number of cardiometabolic diseases increased, so did the prevalence of frailty, and the proportion of healthcare utilization, including outpatient visit and inpatient visit. Moreover, the total healthcare expenditure and the odds of catastrophic health expenditure were increased with the number of cardiometabolic disorders. After adjusting for covariates, cardiometabolic diseases were positively associated with higher odds of frailty, incurring outpatient and inpatient visit. And individuals with 2 or more cardiometabolic diseases had a higher odds of catastrophic health expenditure than persons with non-cardiometabolic disease. Participants who were frailty were more likely to report higher odds of healthcare utilization. These findings suggest that both cardiometabolic diseases and frailty assessment may improve identification of older adults likely to require costly, extensive healthcare.
本研究调查了中国老年人中心血管代谢疾病、虚弱和医疗保健利用与支出之间的关联。参与者为来自中国健康与退休纵向研究的 5204 名至少 60 岁的社区居住成年人。评估了五种心血管代谢疾病,包括高血压、血脂异常、糖尿病、心脏疾病和中风。虚弱状况基于五个标准:缓慢、虚弱、疲惫、不活动和消瘦。如果满足至少三个标准,则认为参与者患有虚弱症。随着心血管代谢疾病数量的增加,虚弱的患病率以及包括门诊和住院就诊在内的医疗保健利用率也随之增加。此外,随着心血管代谢紊乱数量的增加,总医疗支出和灾难性健康支出的可能性也会增加。在调整了协变量后,心血管代谢疾病与虚弱、门诊和住院就诊的可能性增加呈正相关。与非心血管代谢疾病患者相比,患有两种或更多心血管代谢疾病的个体发生灾难性健康支出的可能性更高。虚弱的参与者更有可能报告医疗保健利用率更高的可能性。这些发现表明,心血管代谢疾病和虚弱评估都可能改善对需要昂贵、广泛医疗保健的老年人的识别。