Deakin University, Deakin Health Economics, School of Health and Social Development, Geelong, Victoria, 3220, Australia.
Monash University, School of Public Health and Preventive Medicine, Health Economics Division, Melbourne, Australia.
Soc Sci Med. 2024 May;348:116821. doi: 10.1016/j.socscimed.2024.116821. Epub 2024 Mar 27.
The demanding nature of caregiving and limited social support can lead to informal carers experiencing loneliness, which can impact their well-being and overall health service use (HSU). The study aims to examine the association between loneliness with HSU and Health state utility values among informal carers in Australia.
Data were derived from three waves (2009, 2013, and 2017) of the nationally representative longitudinal Household Income and Labour Dynamics of Australia (HILDA) survey, focusing on adult informal carers. Outcome measures included visits to the General Practitioner, the number of hospital admissions, and the SF-6D score. Generalized Estimating Equations (GEE) analysis was conducted to explore the associations between loneliness and HSU, as well as loneliness and utility values (based on SF-6D) while adjusting for age, sex, education, marital status, income, and physical/mental health conditions.
After controlling for covariates, lonely carers reported lower utility values (IRR = 0.91, 95%CI [0.89, 0.93], p < 0.001) compared to non-lonely carers. Lonely carers reported a higher number of GP visits (IRR = 1.18, 95% CI [1.04, 1.36], p < 0.05) as well as a higher likelihood of visiting specialists (AOR = 1.31, p = 0.046) and hospital doctors (AOR = 1.42, p = 0.013) compared to the non-lonely carers.
The findings of this study highlight the relationship between loneliness on both healthcare utilization and carers' overall well-being. Addressing loneliness through targeted interventions and social support systems can help improve health outcomes and potentially reduce the overall healthcare costs among informal carers in Australia.
照顾者的工作性质要求高,社会支持有限,这可能导致非正式照顾者感到孤独,从而影响他们的幸福感和整体医疗服务利用(HSU)。本研究旨在探讨澳大利亚非正式照顾者孤独感与 HSU 以及健康状态效用值之间的关系。
数据来自澳大利亚全国代表性纵向家庭收入和劳动力动态调查(HILDA)的三个波次(2009 年、2013 年和 2017 年),重点关注成年非正式照顾者。结果测量包括看全科医生的次数、住院人数和 SF-6D 得分。采用广义估计方程(GEE)分析,在调整年龄、性别、教育程度、婚姻状况、收入和身体/心理健康状况后,探讨孤独感与 HSU 以及孤独感与效用值(基于 SF-6D)之间的关系。
在控制了协变量后,孤独的照顾者报告的效用值较低(IRR=0.91,95%CI[0.89,0.93],p<0.001),与不孤独的照顾者相比。孤独的照顾者看全科医生的次数更多(IRR=1.18,95%CI[1.04,1.36],p<0.05),看专科医生和医院医生的可能性也更高(AOR=1.31,p=0.046)和(AOR=1.42,p=0.013),与不孤独的照顾者相比。
本研究结果强调了孤独感对医疗保健利用和照顾者整体幸福感的影响。通过有针对性的干预措施和社会支持系统来解决孤独感问题,可以帮助改善健康结果,并有可能降低澳大利亚非正式照顾者的整体医疗保健成本。