Association of home-and community-based services with health-related quality of life among Chinese older adults

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PURPOSES: Home-and community-based services (HCBS) are becoming increasingly popular globally to meet the challenges of ageing populations. This study aims to investigate whether HCBS utilizing was associated with higher health related quality of life (HRQoL) in older adults, and to explore how this association may vary across populations with different demographic and socioeconomic characteristics. METHODS: The data used in this study were derived from the China Health and Retirement Longitudinal Study in 2018. Ordinary least squares regression was employed to assess the association between HCBS and EQ-5D-3 L score in older adults, while the impact of HCBS on each health dimension separately could be examined by ordered-logit regression. Entropy balancing was used to verify the robustness of the regression results. RESULTS: A total number of 7,586 participants were recruited into this study. The results showed that older adults who had received HCBS reported significantly higher EQ-5D-3 L scores (coefficient = 0.013, p < 0.001) compared with those who had not received HCBS, which mainly due to the positive effects of HCBS on the health dimensions of self-care (OR = 0.530, p < 0.001), usual activity (OR = 0.720, p < 0.001), and anxiety/depression (OR = 0.829; p = 0.001). The older adults with chronic diseases, single or living in rural areas were found to benefit more from HCBS. CONCLUSION: HCBS may increase the level of self-perceived health for older adults by providing daily care support, promoting social participation, and alleviating psychological stress. To improve the health of older adults, it is recommended to further expand the coverage of HCBS, prioritize those who are likely to benefit from it (e.g., single, chronically ill, and rural older adults), and optimize the interventions for pain management and mobility support.

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