Background Multimorbidity pose challenges to older adults' health services. It is of great importance to explore its impact on health services utilization in the elderly. The Chinese Multimorbidity-Weighted Index(CMWI)has been developed to measure the burden of multimorbidity in Chinese middle-aged and elderly,but there is a lack of cohort studies on the association between CMWI and health service utilization. Objective To explore the association between burden of multimorbidity and utilization of health among older adults,which provides scientific evidence for improving the intervention and management of older adults' patients with multimorbidity. Methods From December 2021 to January 2024,taking Sihui City of Zhaoqing City,Guangdong Province as an example,the electronic health records of residents from 2017 to 2021 were collected from the city's national health information platform to establish a natural population cohort for health examination of the elderly. We used the time of the first health examination in this period as the baseline,the CMWI was used to measure individual's baseline burden of multimorbidity .We use the negative binomial regression to analyze the association between individual's CMWI respectively and the total number of outpatient visits,chronic disease-related outpatient visits,total number of hospitalizations and chronic disease-related hospitalizations during the follow-up period. Results Among the total 39989 participants,there were 14991(55.18％) cases of multimorbidity,and the CMWI was 1.3(0,2.3). During an average 1268 days follow-up period,26141 people(65.37％) had used outpatient services,the number of total outpatient visits and chronic disease-related outpatient visits was 2(0,6) and1(0,4). In our study 7332(18.34％)had used hospitalization services,the number of total hospitalization and chronic disease-related hospitalization was 0(0,0)and 0(0,0). Age,genders,education levels and CMWI varied significantly by the utilization of health(P<0.05). The residential type varied significantly by the utilization of outpatient services(P<0.05) but no by utilization of inpatient services(P>0.05). After adjusting the covariates of age,gender,residence and education levels,negative binomial regression analysis showed that CMWI was a risk factor on the increase of health service utilization in the elderly(IRR>1). For each unit increase in CMWI,the total number of outpatient visits increased by 1.210(95％CI=1.196-1.224),the number of chronic disease-related outpatient visits increased by 1.276(95％CI=1.259-1.292),the total number of hospitalizations increased by 1.277(95％CI=1.244-1.312),and the number of chronic disease-related hospitalizations increased by 1.286(95％CI=1.252-1.321). Conclusion CMWI is a risk factor for the increase of health service utilization in the elderly,and the number of health service utilization in the elderly increases with the increase of CMWI. More attention should be paid to the burden of multi-chronic diseases in the elderly,so as to provide scientific basis for improving the intervention and management of multi-chronic diseases in the elderly in China.
MultimorbidityAgedHealth servicesNegative binomial regressionChinese multimorbidity-weighted index
维普
万方数据
