Association between multimorbidity trajectories, healthcare utilization, and health expenditures among middle-aged and older adults: China Health and Retirement Longitudinal Study

Zhang, Zeyun; Yuan, Manqiong; Shi, Kanglin; Xu, Chuanhai; Lin, Jianlin; Shi, Zaixing; Fang, Ya

doi:10.1016/j.jad.2023.02.135

Cited by 4 publications

(4 citation statements)

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“…7 8 In particular, several studies have successfully identified distinct subgroups of multimorbidity within study populations. [9][10][11] Similar groups emerged across these studies, including a group of older individuals maintaining few conditions, a group characterised by a consistently high number of conditions and a group of individuals reporting a rapidly increasing number of conditions. 12 13 To our knowledge, however, no study has examined heterogeneous multimorbidity trajectories by longitudinally capturing the accumulation of chronic conditions throughout the whole period starting from an individual's first-onset condition to his or her very old age.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 74%

“…Recent research has indicated that older individuals not only show variations in the timing of disease onset but also develop multimorbidity at different rates over time 7 8. In particular, several studies have successfully identified distinct subgroups of multimorbidity within study populations 9–11. Similar groups emerged across these studies, including a group of older individuals maintaining few conditions, a group characterised by a consistently high number of conditions and a group of individuals reporting a rapidly increasing number of conditions 12 13.…”

Section: Introductionmentioning

confidence: 99%

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Exposure to early-life adversity and long-term trajectories of multimorbidity among older adults in China: analysis of longitudinal data from the China Health and Retirement Longitudinal Study

Liu,

Zhang,

Zhang

et al. 2024

BMJ Open

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ObjectivesThis study aimed to identify long-term distinct trajectories of multimorbidity with ageing from 50 to 85 years among Chinese older adults and examine the relationship between exposure to early-life adversity (ELA; including specific types of adversity and accumulation of different adversities) and these long-term multimorbidity trajectories.DesignThe group-based trajectory models identified long-term multimorbidity trajectories. Multinomial logistic regression models were used to examine the relationship between ELA and the identified multimorbidity trajectories.SettingThis study used data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018) and the 2014 Life History Survey.ParticipantsWe used data from 9112 respondents (aged 60 and above) of the 2018 wave of CHARLS.Outcome measuresEach respondent’s history of chronic conditions and experiences of ELA were collected from the 2011–2018 waves of CHARLS and the 2014 Life History Survey.ResultsFour heterogeneous long-term trajectories of multimorbidity development were identified: ‘maintaining-low’ (19.1%), ‘low onset-rapidly increasing’ (23.3%), ‘middle onset-moderately increasing’ (41.5%) and ‘chronically-high’ (16.2%). Our findings indicated that the heterogeneity can be explained by ELA experiences. Across various types of different ELA experiences, exposure to food insufficiency (relative risk ratios from 1.372 (95% CI 1.190 to 1.582) to 1.780 (95% CI 1.472 to 2.152)) and parental quarrel/divorce (relative risk ratios from 1.181 (95% CI 1.000 to 1.394) to 1.262 (95% CI 1.038 to 1.536)) had the most prominent associations with health deterioration. The accumulation of more different ELA experiences was associated with a higher relative risk of developing more severe multimorbidity trajectories (relative risk ratio for five to seven ELAs and chronically high trajectory: 7.555, 95% CI 4.993 to 11.431).ConclusionsThere are heterogeneous long-term trajectories of multimorbidity in Chinese older adults, and the risk of multimorbidity associated with ELA accumulates over the lifespan. Our findings highlight the role of a supportive early-life family environment in promoting health development across the lifespan, advocating for the integration of life-course approaches to implementing health disparity interventions.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Exposure to early-life adversity and long-term trajectories of multimorbidity among older adults in China: analysis of longitudinal data from the China Health and Retirement Longitudinal Study

Liu,

Zhang,

Zhang

et al. 2024

BMJ Open

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“…However, many healthcare systems across countries primarily concentrate on managing individual diseases rather than addressing the complexities of morbidities. CMM denotes the concurrent presence of two or more such diseases and is linked to heightened risks of mortality (1)(2)(3), disability(4), cognitive decline (5)(6)(7), diminished quality of life(8), and adv erse drug events (9),This places a substantial burden on both China's healthcare system and society at large (10,11). The high prevalence and intricate nature of morbidities present signi cant challenges in managing healthcare resources effectively.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Survey of Cardiometabolic Multimorbidity and Related Risk Factors in Chinese Population: A Cross-Sectional Study

Xu,

Wang,

Wang

et al. 2024

Preprint

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Background The widespread prevalence of Cardiometabolic Multimorbidity (CMM) presents significant challenges to global public health. While previous studies have primarily examined individual cardiometabolic diseases, there has been limited research on CMM. As such, we intend to assess the prevalence of CMM and identify predictive risk factors within the Chinese population which will hold considerable implications for the future management of CMM. Methods We employed data from The China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project (China-PEACE MPP), enrolling a total of 102,358 participants aged 35–75 years. CMM was defined as the simultaneous presence of two or more of the following diseases: diabetes, hypertension, stroke, and coronary heart disease. Univariate and multivariate logistic regression analyses were performed on demographic variables and modifiable factors associated with CMM to identify its risk predictive factors. Results The participants, with an average age of 54.27 years, comprised 60.5% of women. The overall prevalence of CMM was 11.6%, with hypertension and diabetes coexisting as the most common comorbid combination at 8.5%. Multifactor logistic regression analysis revealed that increasing age (45–54 years (OR = 2.62, 95%CI: 2.39–2.88), 55–64 years (OR = 5.27, 95%CI: 4.83–5.78), and 65–75 years (OR = 8.36, 95%CI: 7.62–9.18) compared to 35–44 years), current alcohol consumption (OR = 1.23, 95%CI: 1.12–1.34), TG ≥ 2.3mmol/L (OR = 1.69, 95%CI: 1.61–1.78), recent use of lipid-lowering medications (OR = 3.47, 95%CI: 3.21–3.74), and recent use of antiplatelet aggregators (OR = 3.67, 95%CI: 3.33–4.04) were associated with an increased risk of CMM. Conversely, a reduced occurrence of CMM was associated with being female (OR = 0.74, 95%CI: 0.70–0.78), other marital statuses (OR = 0.91, 95%CI: 0.85–0.97), education level of high school or above (OR = 0.90, 95%CI: 0.85–0.94), annual household income not less than 50,000 yuan (OR = 0.93, 95% CI: 0.89–0.98, p = 0.004), and HDL-C ≥ 1.0mmol/L (OR = 0.84, 95%CI: 0.79–0.90). Conclusions In the general population of China, over one-tenth of individuals are affected by CMM, indicating a high current prevalence of the condition. This highlights the imperative for China to develop targeted intervention measures focusing on the risk factors of CMM to prevent its occurrence and progression, effectively manage the condition, and reduce associated adverse outcomes and healthcare resource consumption.

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“…This not only provides new information for sports economics and health economics but also provides a theoretical basis for a sustainable supply of public sports services. Second, we incorporate both public sports services and public health services into our research model, which differs from the majority of literature that focuses solely on whether public health services significantly improve health ( 17 , 18 ). The strong health effects of interaction between the two are revealed.…”

Section: Introductionmentioning

confidence: 99%

Health effect of public sports services and public health services: empirical evidence from China

Cao,

Cai,

Gong

et al. 2024

Front. Public Health

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There is no clear explanation for the extraordinary rebound in China’s population mortality over the past decade. This paper utilizes panel data from 31 Chinese provinces from 2010 to 2020 to determine the distinct impacts of public sports services (PSS), public health services (PMS), and their interaction on population mortality. Empirical results show that public sports services significantly reduce mortality. Every unit increase in public sports services reduces mortality by about 2.3%. It is characterized by delayed realization. Public health services were surprisingly associated with a rebound in mortality. Further studies found strong health effect from interaction of public sports and health services. The effect was significantly strengthened in areas with fewer extreme temperatures or developed economy. The findings have important policy implications for the high-quality development of public sports and health services. It also emphasizes integration of sports and medicine and mitigates health risks associated with extreme temperatures.

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Association between multimorbidity trajectories, healthcare utilization, and health expenditures among middle-aged and older adults: China Health and Retirement Longitudinal Study

Cited by 4 publications

References 44 publications

Exposure to early-life adversity and long-term trajectories of multimorbidity among older adults in China: analysis of longitudinal data from the China Health and Retirement Longitudinal Study

Exposure to early-life adversity and long-term trajectories of multimorbidity among older adults in China: analysis of longitudinal data from the China Health and Retirement Longitudinal Study

Epidemiological Survey of Cardiometabolic Multimorbidity and Related Risk Factors in Chinese Population: A Cross-Sectional Study

Health effect of public sports services and public health services: empirical evidence from China

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