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. 2024 Mar 11;23(1):51.
doi: 10.1186/s12939-023-02057-4.

Catastrophic health expenditure and health-related quality of life among older adults in Shandong, China: the moderation effect of daily care by adult children

Jiayan Li  1 , Tingting Gao  1 , Dan Zhao  1 , Shujun Chai  1 , Jingjing Luo  1 , Xuehong Wang  1 , Xueqing Wang  1 , Jingjie Sun  2 , Peilong Li  2 , Chengchao Zhou  3   4   5
Affiliations

Catastrophic health expenditure and health-related quality of life among older adults in Shandong, China: the moderation effect of daily care by adult children

Jiayan Li et al. Int J Equity Health. .

Abstract

Background: Catastrophic health expenditure (CHE) has a considerable impact on older people in later life, but little is known about the relationship between catastrophic health expenditure and health-related quality of life (HRQOL). The aim of this study was to examine the relationship between catastrophic health expenditure and health-related quality of life in older people, and to explore whether the daily care provided by adult children is a moderator in this relationship.

Methods: Data from the sixth National Health Services Survey in Shandong Province, China. The sample consisted of 8599 elderly people (age ≥ 60 years; 51.7% of female). Health-related quality of life was measured by the health utility value of EQ-5D-3 L. Interaction effects were analyzed using Tobit regression models and marginal effects analysis.

Results: The catastrophic health expenditure prevalence was 60.5% among older people in Shandong, China. catastrophic health expenditure was significantly associated with lower health-related quality of life (β= - 0.142, P < 0.001). We found that adult children providing daily care services to their parents mitigated the effect of catastrophic health expenditure on health-related quality of life among older people (β = 0.027, P = 0.040).

Conclusions: Our findings suggested that catastrophic health expenditure was associated with health-related quality of life and the caring role of older adult children moderated this relationship. Reducing the damage caused by catastrophic health expenditure helps to improve health-related quality of life in older people. Adult children should increase intergenerational contact, provide timely financial and emotional support to reduce the negative impact of catastrophic health expenditure on health-related quality of life.

Keywords: Adult children; Catastrophic health expenditure; Daily life caregiver; Health-related quality of life.

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Conflict of interest statement

The authors declare no competing interests.

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Flowchart of the study sample
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