Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adults
Background Chronic disease multimorbidity has become a major challenge for health systems. While a lot of research has evaluated the direct economic burden of multimorbidity on health care utilization and cost, little attention has been given to the impacts on work productivity and functional limita...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2021.1975921 |
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| author | Yang Zhao Li He Chunlei Han Brian Oldenburg Grace Sum Tilahun Nigatu Haregu Xiaoyun Liu |
| author_facet | Yang Zhao Li He Chunlei Han Brian Oldenburg Grace Sum Tilahun Nigatu Haregu Xiaoyun Liu |
| author_sort | Yang Zhao |
| collection | DOAJ |
| description | Background Chronic disease multimorbidity has become a major challenge for health systems. While a lot of research has evaluated the direct economic burden of multimorbidity on health care utilization and cost, little attention has been given to the impacts on work productivity and functional limitations, as indirect indicators of disease burden. Objectives This study aims to examine the prevalence of multimorbidity among Chinese adults and its impact on functional disability and work productivity. It also investigates urban-rural differences in these relationships. Method This study utilized the data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, including 11,176 participants aged 45 years and older. Multivariable logistic regression models were used to estimate the effect of multimorbidity on functional disability (i.e. ADL: activities of daily life; IADL: instrumental activities of daily life), and work productivity loss due to health problems. Negative binomial regression models were used to assess the association of multimorbidity with sickness absences from agricultural work and employed non-agricultural work. Results 68.8% of total participants in CHARLS had multimorbidity in China in 2015. Rural residents with multimorbidity reported higher proportions of physical functions and days of sick leave than urban residents. Multimorbidity was positively associated with ADL limitation (odds ratio 1.924, 95% CI 1.656–2.236), IADL limitation (1.522, 1.326–1.748), limited work due to health problems (1.868, 1.601–2.178) and days of sick leave (for agricultural work, incidence rate ratio 1.676, 95% CI 1.390–2.020; for employed non-agricultural work, 2.418, 1.245–4.696). For the rural group, the impact of multimorbidity on functional limitations and work productivity loss (except for early retirement), was less than the urban group. Conclusions Multimorbidity poses significant challenges for functional health and work productivity These have significant negative economic consequences for individuals, the Chinese health system and the society. |
| format | Article |
| id | doaj-art-04299c680db44e138b4d3915ab1fcaed |
| institution | Kabale University |
| issn | 1654-9880 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj-art-04299c680db44e138b4d3915ab1fcaed2025-08-20T03:46:52ZengTaylor & Francis GroupGlobal Health Action1654-98802021-01-0114110.1080/16549716.2021.19759211975921Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adultsYang Zhao0Li He1Chunlei Han2Brian Oldenburg3Grace Sum4Tilahun Nigatu Haregu5Xiaoyun Liu6The George Institute for Global Health at Peking University Health Science CenterBeijing Normal UniversityBinzhou Medical University, YantaiBaker Heart and Diabetes InstituteNational University of SingaporeBaker Heart and Diabetes InstitutePeking UniversityBackground Chronic disease multimorbidity has become a major challenge for health systems. While a lot of research has evaluated the direct economic burden of multimorbidity on health care utilization and cost, little attention has been given to the impacts on work productivity and functional limitations, as indirect indicators of disease burden. Objectives This study aims to examine the prevalence of multimorbidity among Chinese adults and its impact on functional disability and work productivity. It also investigates urban-rural differences in these relationships. Method This study utilized the data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, including 11,176 participants aged 45 years and older. Multivariable logistic regression models were used to estimate the effect of multimorbidity on functional disability (i.e. ADL: activities of daily life; IADL: instrumental activities of daily life), and work productivity loss due to health problems. Negative binomial regression models were used to assess the association of multimorbidity with sickness absences from agricultural work and employed non-agricultural work. Results 68.8% of total participants in CHARLS had multimorbidity in China in 2015. Rural residents with multimorbidity reported higher proportions of physical functions and days of sick leave than urban residents. Multimorbidity was positively associated with ADL limitation (odds ratio 1.924, 95% CI 1.656–2.236), IADL limitation (1.522, 1.326–1.748), limited work due to health problems (1.868, 1.601–2.178) and days of sick leave (for agricultural work, incidence rate ratio 1.676, 95% CI 1.390–2.020; for employed non-agricultural work, 2.418, 1.245–4.696). For the rural group, the impact of multimorbidity on functional limitations and work productivity loss (except for early retirement), was less than the urban group. Conclusions Multimorbidity poses significant challenges for functional health and work productivity These have significant negative economic consequences for individuals, the Chinese health system and the society.http://dx.doi.org/10.1080/16549716.2021.1975921multimorbidityfunctional limitationswork productivitychina |
| spellingShingle | Yang Zhao Li He Chunlei Han Brian Oldenburg Grace Sum Tilahun Nigatu Haregu Xiaoyun Liu Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adults Global Health Action multimorbidity functional limitations work productivity china |
| title | Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adults |
| title_full | Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adults |
| title_fullStr | Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adults |
| title_full_unstemmed | Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adults |
| title_short | Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adults |
| title_sort | urban rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among chinese adults |
| topic | multimorbidity functional limitations work productivity china |
| url | http://dx.doi.org/10.1080/16549716.2021.1975921 |
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