Abstract
Purpose: The dependence of patients with chronic diseases on drugs may affect their health-related quality of life (HRQoL). This study aims to assess the relationship between the direct economic burden caused by out-of-pocket (OOP) payments, drug accessibility, sociodemographic characteristics, and health-related quality of life.Methods: 1,055 patients with chronic diseases from Gansu, Hebei, Sichuan, Zhejiang, and Tianjin were investigated. Data collection included basic conditions and economic and health insurance conditions of patients with chronic diseases. The CLAD and Tobit regression models were used to analyze and compare the health-related quality of life and influencing factors of patients with chronic diseases in five districts. Differentiated analysis was conducted through sub-sample regression to explore the variable health effects of patients with single and multiple diseases.Results: A total of 1,055 patients with chronic diseases participated in the study, 54.4% of whom were women. The overall average utility score was 0.727, of which Sichuan Province was the highest with 0.751. Participants reported the highest proportion of pain/discomfort problems, while patients reported the least problems with self-care. The improvement of drug accessibility and the reduction of the burden of out-of-pocket expenses have significant positive effects on HRQoL. Various sociodemographic factors such as age and gender also have significant impact on HRQoL of patients with chronic diseases. HRQoL of patients with multiple chronic diseases is more affected by various influencing factors than that of patients with single disease.Conclusion: In order to improve the quality of life of patients with chronic diseases, it is of great importance to ensure the accessibility of drugs and reduce patients' medication burden. Future focus should shift from preventing and controlling chronic diseases as individual diseases to meeting the comprehensive health needs of people suffering from multiple diseases.
Highlights
Chronic diseases are called non-communicable diseases (NCD)
This study finds that the increase in OOP affordability significantly improves the health-related quality of life of patients with chronic diseases, which is consistent with previous findings [25]
This study explores the differential factors affecting health-related quality of life of patients with single disease and multiple diseases through heterogeneity analysis, and finds that the health-related quality of life of patients with multiple chronic diseases is more affected by various variables than those with single disease
Summary
Chronic diseases are called non-communicable diseases (NCD). From a macro perspective, this type of disease causes 41 million deaths each year, equivalent to 71% of deaths worldwide. 15 million people die between the ages of 30 and 69, and such premature deaths mostly occur in low- and middle-income countries [1]. 15 million people die between the ages of 30 and 69, and such premature deaths mostly occur in low- and middle-income countries [1] These countries suffer from direct losses in productivity and medical care due to the high incidence of chronic diseases, which in turn brings a huge economic burden to the country and inhibits its sustainable development [2]. It is necessary to evaluate the health-related quality of life of patients with chronic diseases from multiple perspectives such as physical, mental, and social environment. HRQoL is a multidimensional concept involving general functional status and symptoms related to disease or treatment [6] It involves the functional stability of a person’s mental, physical, and social dimensions, and can fully reflect the interaction between the individual and the society [7]. This study measured the HRQoL of patients with chronic diseases to enable us to understand the health characteristics of this population
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