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

• Main Authors: Jiao Zhang, Lingzhong Xu, Jiajia Li, Long Sun, Gan Ding, Wenzhe Qin, Qian Wang, Jing Zhu, Zihang Yu, Su Xie
• Format: Article
• Language: English
• Published: MDPI AG 2018-07-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: elderly; loneliness; health service utilization
• Online Access: http://www.mdpi.com/1660-4601/15/7/1468

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.