Chronic condition change and its longitudinal association with health care utilization among rural older adults: intergenerational financial support as a possible moderator?

Oct 15, 2024BMC geriatrics

Long-term health condition changes and health care use in rural older adults: possible influence of financial support from family

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Abstract

Older individuals with progressive chronic conditions used 5.32 times more inpatient services compared to those with no chronic conditions.

Progressive chronic conditions are linked to increased outpatient and inpatient health care utilization among older adults.
Older adults with no chronic conditions transitioning to emerging showed significant increases in service usage.
may reduce outpatient service utilization for older adults with multimorbidity.
The association between chronic condition progression and health care utilization warrants ongoing monitoring and intervention.

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BACKGROUND: The prevalence of chronic conditions increases rapidly among older population. However, it is unclear how different chronic conditions progression contributes to the health care utilization, and whether intergenerational support modified this relationship. This study aimed to explore the longitudinal link between chronic condition progression and health care utilization, and examine whether is a moderator in this relationship among Chinese rural older people.

METHODS: Data was derived from the Shandong Rural Elderly Health Cohort (SREHC), which was conducted from 2019 to 2020. A total of 2,785 participants were included in this study. Kruskal-Wallis rank tests and generalized estimating equation (GEE) models were employed to analyze the association between chronic condition progression and health care utilization. Moderating effect analysis was performed using GEE model and margins plot.

RESULTS: Older people with progressive chronic conditions used more outpatient (no chronic condition to emerging : OR = 1.83; p = 0.028; one chronic condition to emerging multimorbidity: OR = 2.17; p < 0.001; remained multimorbidity while chronic conditions increased: OR = 3.26; p < 0.001) and inpatient services (no chronic condition to emerging multimorbidity: OR = 2.76; p < 0.001; one chronic condition to emerging multimorbidity: OR = 3.40; p < 0.001; remained multimorbidity while chronic conditions increased: OR = 5.32; p < 0.001) than those remained no chronic conditions. Intergenerational financial support may alleviate outpatient utilization of older people with multimorbidity (remained multimorbidity × intergenerational financial support: OR = 0.40; p = 0.013; remained multimorbidity while chronic conditions increased × intergenerational financial support: OR = 0.35; p = 0.019).

CONCLUSION: This study showed that the changes of chronic condition were associated with health care utilization, and intergenerational financial support moderated this relationship. It is vital to continuously monitor and timely intervene the chronic condition progression among rural older people.

Key numbers

3.26

Increased Outpatient Utilization

Odds ratio for outpatient services among those with progressive .

0.40

Reduced Outpatient Utilization with Support

Odds ratio for outpatient services among those with unchanged receiving financial support.

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Chronic condition change and its longitudinal association with health care utilization among rural older adults: intergenerational financial support as a possible moderator?

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