Loneliness and Health Service Utilization among the Rural Elderly in Shandong, China: A Cross-Sectional Study

Int J Environ Res Public Health. 2018 Jul 11;15(7):1468. doi: 10.3390/ijerph15071468.

Abstract

Objectives: To examine the prevalence of loneliness and to explore the association between loneliness and health service utilization among the rural elderly in Shandong Province, China.

Methods: A total of 5514 rural people aged 60 and above from Shandong Province, China, were enrolled in this study. Loneliness was used as a binary variable based on a single-item question. Health service utilization was measured by recent two-week physician visits and annual hospitalizations rates. Multiple logistic regression analysis was performed to examine the association between loneliness and health service utilization.

Results: The prevalence of loneliness among the rural elderly in Shandong, China, was 25.0%. Loneliness was associated with higher rates of recent two-week physician visits (OR = 1.260, p < 0.01) and annual hospitalizations (OR = 1.183, p < 0.05). The regression results also showed that self-rated health status and chronic conditions were significant and positively associated with both physician visits and hospitalizations rates.

Conclusions: Loneliness had a significant association with higher odds of health service utilization among the elderly. The independent contribution of loneliness on health service utilization was smaller than self-rated health status and chronic conditions. Thus, healthcare policies need to shift from an emphasis on controlling health utilization and cost to a greater focus on enabling lonely older people to get more social support.

Keywords: elderly; health service utilization; loneliness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • China
  • Cross-Sectional Studies
  • Female
  • Health Care Surveys
  • Hospitalization / statistics & numerical data
  • Humans
  • Logistic Models
  • Loneliness*
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Rural Population*
  • Social Support