基于EQ-5D-3L的宁夏回族自治区农村居民健康相关生命质量与卫生服务利用的关系研究

Background ?Exploring the factors affecting health service utilization is of great significance for optimizing the allocation of health services. Health-related quality of lifeHRQoLfocuses on individuals' subjective self-assessment of their current health statusand may affect their health-seeking behaviorsbut there are few studies on the impact of HRQoL on health service utilization of rural residents in China. Objective ?To explore the relationship between HRQoL and health service utilization of rural residents in Ningxia Hui Autonomous Regionand to provide a reference for the development of relevant policies/plansand for the optimization health services in rural areas. Methods ?Data were collected from the Health Survey of Rural Residents Families 2019 conducted in four sample counties of NingxiaHaiyuanPengyangXijiYanchifrom July to August 2019involving 9 310 cases≥15yearswith complete key informationgenderageHRQoL-related indicatorshealth service utilization indicators. Detailed data of the residents were extractedincluding socio-economic and demographic characteristicshealth services accessibilityprevalence of chronic diseasesHRQoL measured using European Quality of Life 5 Dimensions 3 Level VersionEQ-5D-3Land utilization of health services. The effects of health state utility values and visual analog scaleVASscore on outpatient and inpatient health service utilization were analyzed by binary Logistic regression. Results ?The utilization rates of outpatient and inpatient health services of rural residents in Ningxia were 10.85%1 010/9 310and 18.86%1 756/9 310respectively. The mean health state utility values and mean VAS score of them were0.965±0.090and69.97±17.84respectively. Difference testing showed that residents with impaired self-carein the EQ-5D-3L descriptive systemhad higher rates of using outpatient health servicesOR95%CI=3.1972.6333.883P<0.001and inpatient health servicesOR95%CI=4.8024.0595.681P<0.001compared with those with impaired mobilityusual activitiesor higher level of pain/discomfort or anxiety/depression. Binary Logistic regression analysis showed that after adjusting for various confounding factorshealth state utility values and VAS score were associated with the use of outpatient and inpatient health servicesP<0.05. Moreoverthe prevalence of chronic diseases also significantly affect the utilization of outpatient and inpatient health servicesP<0.05. Conclusion ?HRQoL and the prevalence of chronic diseases were leading factors affecting the utilization of outpatient and inpatient services in Ningxia rural residents. As an independent predictive factor of residents' health service utilizationHRQoL can be used to assist in the evaluation and monitoring of health service quality and effectand provide guidance for rational allocation of health resources.