Association of sensory impairment with healthcare use and costs among middle-aged and older adults in China

Objectives: This study aimed to explore the association of visual, hearing, or dual sensory impairment with healthcare use and costs. Study design: This is a cohort study. Methods: These research data were from the China Health and Retirement Longitudinal Study spanning 2011-2018 and included 8982 community-dwelling middle-aged and older adults (aged >= 45 years at baseline). Sensory impairment was measured according to self-reported assessment of visual and hearing functions, and healthcare use and costs were ascertained via self-report. The associations of sensory impairment with healthcare use and costs were estimated using the mixed-effects regression models. Results: Of the 8982 respondents, 4346 (48.39%) were females and their mean (standard deviation) age at baseline was 57.03 (8.26) years. Individuals with hearing impairment (HI) only, visual impairment (VI) only, and dual sensory impairment (DSI) were all at significantly higher risks of healthcare use and catastrophic health expenditure than those without sensory impairment (all P < 0.05), except that VI only non-significantly prolonged inpatient days. Compared with no impairment, DSI was associated with increases in outpatient (beta = 50.67, 95% confidence interval [CI] = 17.47-83.86) and inpatient out-ofpocket costs (beta = 40.35, 95% CI = 5.94-74.76), while VI only or HI only did not show significant effects. Further stratification analyses indicated that the associations between sensory impairment and outpatient use were more pronounced among males than among females but that age group did not moderate the associations with any healthcare outcomes. Conclusions: HI and VI were independently and together associated with higher risks of healthcare use and catastrophic health expenditure. Dual sensory impairment was the only category consistently associated with increased outpatient and inpatient costs. (C) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study aimed to explore the association of visual, hearing, or dual sensory impairment with healthcare use and costs. The research data were obtained from the China Health and Retirement Longitudinal Study and included 8982 middle-aged and older adults. Sensory impairment was measured through self-reported assessment of visual and hearing functions, and healthcare use and costs were determined via self-report. The results showed that individuals with hearing impairment, visual impairment, or dual sensory impairment were at higher risks of healthcare use and catastrophic health expenditure compared to those without sensory impairment.