The association between mental-physical multimorbidity and disability, work productivity, and social participation in China: a panel data analysis.
The association between mental-physical multimorbidity and disability, work productivity, and social participation in China: a panel data analysis.
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DOI：
10.1186/s12889-021-10414-7
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发表时间：
2021-02-18
影响因子：
4.5
通讯作者：
Lee JT
中科院分区：
文献类型：
--
作者：
Pan T;Mercer SW;Zhao Y;McPake B;Desloge A;Atun R;Hulse ESG;Lee JT
精神和身体慢性病的共存（精神-身体多重病症）是低收入和中等收入国家卫生系统和更广泛经济体面临的一个日益严重但基本上未得到解决的挑战。本研究调查了身心慢性疾病对残疾、工作效率和社会参与的独立和联合（加性或协同）影响。面板数据研究设计利用了中国健康与退休纵向研究（2011年、2015年）的两波数据，包括5616名年龄≥45岁、12种身体慢性疾病和抑郁症的参与者。我们使用随机效应回归模型的面板数据方法来评估精神-身体多病与预后之间的关系。在对社会经济和人口因素进行调整后，身体慢性疾病数量的增加与更高的残疾可能性独立相关(调整优势比(AOR) = 1.39；95% CI: 1.33, 1.45)、提前退休（AOR = 1.37[1.26, 1.49]）和增加病假天数（1.25天[1.16,1.35]）。抑郁与残疾（AOR = 3.78[3.30, 4.34]）、病假天数增加（2.18天[1.72,2.77]）和社会参与可能性降低（AOR = 0.57[0.47, 0.70]）独立相关，但与提前退休无关（AOR = 1.24[0.97, 1.58]）。身体慢性疾病和心理健康在残疾、工作效率和社会参与方面的相互作用很小，且在统计上不显著，这表明精神-身体多重疾病对生产力损失有累加效应。精神-身体多重疾病对个人、卫生系统和社会造成严重的负面健康和经济影响。需要更多的研究来解决精神和身体多重疾病的挑战，以便为可应用于中国工作场所和更广泛社区的干预措施的发展提供信息。在线版本包含补充材料，可在10.1186/s12889-021-10414-7获得。
The co-occurrence of mental and physical chronic conditions (mental-physical multimorbidity) is a growing and largely unaddressed challenge for health systems and wider economies in low-and middle-income countries. This study investigated the independent and combined (additive or synergistic) effects of mental and physical chronic conditions on disability, work productivity, and social participation in China. Panel data study design utilised two waves of the China Health and Retirement Longitudinal Study (2011, 2015), including 5616 participants aged ≥45 years, 12 physical chronic conditions and depression. We used a panel data approach of random-effects regression models to assess the relationships between mental-physical multimorbidity and outcomes. After adjusting for socio-economic and demographic factors, an increased number of physical chronic conditions was independently associated with a higher likelihood of disability (Adjusted odds ratio (AOR) = 1.39; 95% CI: 1.33, 1.45), early retirement (AOR = 1.37 [1.26, 1.49]) and increased sick leave days (1.25 days [1.16, 1.35]). Depression was independently associated with disability (AOR = 3.78 [3.30, 4.34]), increased sick leave days (2.18 days [1.72, 2.77]) and a lower likelihood of social participation (AOR = 0.57 [0.47, 0.70]), but not with early retirement (AOR = 1.24 [0.97, 1.58]). There were small and statistically insignificant interactions between physical chronic conditions and mental health on disability, work productivity and social participation, suggesting an additive effect of mental-physical multimorbidity on productivity loss. Mental-physical multimorbidity poses substantial negative health and economic effects on individuals, health systems, and societies. More research that addresses the challenges of mental-physical multimorbidity is needed to inform the development of interventions that can be applied to the workplace and the wider community in China. The online version contains supplementary material available at 10.1186/s12889-021-10414-7.
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