Association of sensory impairment with healthcare use and costs among middle-aged and older adults in China

Article

Ding, Yue, Liu, Yingyan, Hou, Xiang-Yu, Tian, Yong, Du, Wei and Fan, Lijun. 2022. "Association of sensory impairment with healthcare use and costs among middle-aged and older adults in China." Public Health. 206, pp. 20-28. https://doi.org/10.1016/j.puhe.2022.02.012
Article Title

Association of sensory impairment with healthcare use and costs among middle-aged and older adults in China

ERA Journal ID13765
Article CategoryArticle
AuthorsDing, Yue, Liu, Yingyan, Hou, Xiang-Yu, Tian, Yong, Du, Wei and Fan, Lijun
Journal TitlePublic Health
Journal Citation206, pp. 20-28
Number of Pages9
Year2022
PublisherElsevier
ISSN0033-3506
1476-5616
Digital Object Identifier (DOI)https://doi.org/10.1016/j.puhe.2022.02.012
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S0033350622000609
Abstract

Objectives
This study aimed to explore the association of visual, hearing, or dual sensory impairment with healthcare use and costs.

Study design
This is a cohort study.

Methods
These research data were from the China Health and Retirement Longitudinal Study spanning 2011–2018 and included 8982 community-dwelling middle-aged and older adults (aged ≥45 years at baseline). Sensory impairment was measured according to self-reported assessment of visual and hearing functions, and healthcare use and costs were ascertained via self-report. The associations of sensory impairment with healthcare use and costs were estimated using the mixed-effects regression models.

Results
Of the 8982 respondents, 4346 (48.39%) were females and their mean (standard deviation) age at baseline was 57.03 (8.26) years. Individuals with hearing impairment (HI) only, visual impairment (VI) only, and dual sensory impairment (DSI) were all at significantly higher risks of healthcare use and catastrophic health expenditure than those without sensory impairment (all P < 0.05), except that VI only non-significantly prolonged inpatient days. Compared with no impairment, DSI was associated with increases in outpatient (β = 50.67, 95% confidence interval [CI] = 17.47–83.86) and inpatient out-of-pocket costs (β = 40.35, 95% CI = 5.94–74.76), while VI only or HI only did not show significant effects. Further stratification analyses indicated that the associations between sensory impairment and outpatient use were more pronounced among males than among females but that age group did not moderate the associations with any healthcare outcomes.

Conclusions
HI and VI were independently and together associated with higher risks of healthcare use and catastrophic health expenditure. Dual sensory impairment was the only category consistently associated with increased outpatient and inpatient costs.

KeywordsSensory impairment; Healthcare use; Healthcare costs; Longitudinal; China
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Byline AffiliationsSoutheast University, China
University of Southern Queensland
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