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Int. J. Environ. Res. Public Health 2018, 15(7), 1468; https://doi.org/10.3390/ijerph15071468

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

1
School of Public Health, Shandong University, Jinan 250012, China
2
Collaborative Innovation Center of Social Risks Governance in Health, School of Public health, Fudan University, Shanghai 200032, China
3
Key Laboratory of Health Economics and Policy Research, School of Public Health, Shandong University, Jinan 250012, China
*
Author to whom correspondence should be addressed.
Received: 1 April 2018 / Revised: 21 June 2018 / Accepted: 10 July 2018 / Published: 11 July 2018
(This article belongs to the Special Issue Mental Health and its Social and Cultural Implications)
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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. View Full-Text
Keywords: elderly; loneliness; health service utilization elderly; loneliness; health service utilization
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Zhang, J.; Xu, L.; Li, J.; Sun, L.; Ding, G.; Qin, W.; Wang, Q.; Zhu, J.; Yu, Z.; Xie, S. Loneliness and Health Service Utilization among the Rural Elderly in Shandong, China: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2018, 15, 1468.

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