The George Institute for Global Health, Sydney, NSW, Australia.
UNSW Medicine, UNSW Sydney, Sydney, NSW, Australia.
Arch Osteoporos. 2023 Feb 10;18(1):29. doi: 10.1007/s11657-023-01220-2.
This study analyzed the impact of hip fractures on people's health-related quality of life and its socio-demographic disparities in China.
Hip fractures cause high mortality and worsened health-related quality of life (HRQoL). This study aimed to investigate whether socio-demographic-related inequities in post-hip fracture participants' HRQoL exist in China.
Data from the China Health and Retirement Longitudinal Study (waves 2013, 2015, and 2018) were used. The measurement of HRQoL in this study focused on 5 health dimensions: depression, body pain, mobility, basic activities of daily living, and instrumental activities of daily living. A difference-in-differences (DID) analysis with multiple time periods was performed to gauge the impact of hip fracture on HRQoL. A multivariate regression approach was used to explore socio-demographic-related factors associated with inequities of HRQoL.
A total of 23,622 individuals were included, and 341 participants reported hip fracture events during the survey period. In participants with hip fracture, the presentation rate of body pain increased by 14% (p < 0.01) and the HRQoL of other health dimensions worsened (p ≤ 0.01) after hip fracture. The DID analysis showed that hip fracture had a negative impact on all HRQoL dimensions (p < 0.01). Socioeconomic-related factors of HRQoL inequities included school education level and location of residence. Study participants with hip fracture with greater educational attainment or living in urban areas had higher (p < 0.05) levels of HRQoL. In addition, comorbidities also correlated with a worse HRQoL (p < 0.05).
Hip fracture significantly affects people's HRQoL in China, and the impact is more profound for those with lower educational attainment or living in rural areas. Targeted interventions should be designed to narrow this inequity.
本研究分析了髋部骨折对中国人群健康相关生活质量的影响及其社会人口学差异。
髋部骨折可导致高死亡率和健康相关生活质量（HRQoL）下降。本研究旨在探讨中国髋部骨折后参与者的 HRQoL 是否存在与社会人口学相关的不平等现象。
使用中国健康与退休纵向研究（2013 年、2015 年和 2018 年）的数据。本研究中 HRQoL 的测量主要集中在 5 个健康维度上：抑郁、身体疼痛、活动能力、基本日常生活活动和工具性日常生活活动。采用具有多个时间点的差值-差值（DID）分析来评估髋部骨折对 HRQoL 的影响。采用多元回归方法探讨与 HRQoL 不平等相关的社会人口学因素。
共纳入 23622 人，341 人在调查期间报告髋部骨折事件。在髋部骨折患者中，身体疼痛的发生率增加了 14%（p<0.01），并且其他健康维度的 HRQoL 恶化（p≤0.01）。DID 分析表明，髋部骨折对所有 HRQoL 维度都有负面影响（p<0.01）。与 HRQoL 不平等相关的社会经济因素包括受教育程度和居住地。髋部骨折的研究参与者中，受教育程度较高或居住在城市地区的人，其 HRQoL 水平更高（p<0.05）。此外，合并症也与更差的 HRQoL 相关（p<0.05）。
髋部骨折在中国显著影响人们的 HRQoL，而对于受教育程度较低或居住在农村地区的人，影响更为深远。应设计有针对性的干预措施来缩小这种不平等。
