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.
Highlights
A World Health Organization (WHO) report on aging and health pointed out that the proportion of the world’s population over 60 years of age will nearly double, from 12% to 22%, between 2015 and 2050 [1]
In a total of 5514 rural elderly, 1381 (25.0%) reported feeling lonely, of which females accounted for 58.1%
Our study extended this research to examine the prevalence of loneliness and its relationship with health service utilization among older adults in China, which has the largest number of the older people in the world
Summary
A World Health Organization (WHO) report on aging and health pointed out that the proportion of the world’s population over 60 years of age will nearly double, from 12% to 22%, between 2015 and 2050 [1]. Consistent with global trends, China is a rapidly aging society, where 230.86 million (16.7%) people were aged 60 and above in 2016 [2]. By the 2030, this number is expected to rise to over 360 million [3]. Many older people live longer but do not necessarily have healthier lives. According to another WHO report, approximately 15% of adults aged 60 and over suffer from a mental disorder, including isolation, loss of independence, loneliness, and psychological distress [4]. Public Health 2018, 15, 1468; doi:10.3390/ijerph15071468 www.mdpi.com/journal/ijerph
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