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Socio-demographic disparities in health-related quality of life after hip fracture in China: evidence from the China Health and Retirement Longitudinal Study

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Abstract

Summary

This study analyzed the impact of hip fractures on people’s health-related quality of life and its socio-demographic disparities in China.

Purpose

Hip fractures cause high mortality and worsened health-related quality of life (HRQoL). This study aimed to investigate whether socio-demographic-related inequities in post-hip fracture participants’ HRQoL exist in China.

Methods

Data from the China Health and Retirement Longitudinal Study (waves 2013, 2015, and 2018) were used. The measurement of HRQoL in this study focused on 5 health dimensions: depression, body pain, mobility, basic activities of daily living, and instrumental activities of daily living. A difference-in-differences (DID) analysis with multiple time periods was performed to gauge the impact of hip fracture on HRQoL. A multivariate regression approach was used to explore socio-demographic-related factors associated with inequities of HRQoL.

Results

A total of 23,622 individuals were included, and 341 participants reported hip fracture events during the survey period. In participants with hip fracture, the presentation rate of body pain increased by 14% (p < 0.01) and the HRQoL of other health dimensions worsened (p ≤ 0.01) after hip fracture. The DID analysis showed that hip fracture had a negative impact on all HRQoL dimensions (p < 0.01). Socioeconomic-related factors of HRQoL inequities included school education level and location of residence. Study participants with hip fracture with greater educational attainment or living in urban areas had higher (p < 0.05) levels of HRQoL. In addition, comorbidities also correlated with a worse HRQoL (p < 0.05).

Conclusion

Hip fracture significantly affects people’s HRQoL in China, and the impact is more profound for those with lower educational attainment or living in rural areas. Targeted interventions should be designed to narrow this inequity.

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Data availability

The data that support the findings of this study are openly available in China Health and Retirement Longitudinal Study (CHARLS) website at http://charls.pku.edu.cn/.

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Funding

Lizheng Xu is supported by an Australian Government Research Training Program Scholarship. Lei Si is supported by a WSU Research Theme Funding. This study was funded by the National Natural Science Foundation of China (grant number: 71874086, 72174093).

Author information

Authors and Affiliations

  1. The George Institute for Global Health, Sydney, NSW, Australia

    Lizheng Xu & Stephen Jan

  2. UNSW Medicine, UNSW Sydney, Sydney, NSW, Australia

    Lizheng Xu

  3. School of Health Policy and Management, Nanjing Medical University, No. 101, Longmian Avenue, Nanjing, 211166, China

    Mingsheng Chen

  4. Creative Health Policy Research Group, Nanjing Medical University, Nanjing, China

    Mingsheng Chen

  5. Center for Global Health, Nanjing Medical University, Nanjing, China

    Mingsheng Chen

  6. National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China

    Ke Peng

  7. Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands

    Mickael Hiligsmann

  8. School of Health Sciences, Western Sydney University, Campbelltown, Australia

    Lei Si

  9. Translational Health Research Institute, Western Sydney University, Penrith, Australia

    Lei Si

Authors
  1. Lizheng Xu
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Contributions

Conceptualization and methodology: Lizheng Xu, Stephen Jan, Mingsheng Chen, and Lei Si; study supervision: Lei Si; formal analysis and investigation: Lizheng Xu; Lizheng Xu prepared the original draft; all authors reviewed, edited, and approved the final manuscript.

Corresponding author

Correspondence to Mingsheng Chen.

Ethics declarations

Ethics approval and consent to participate

The current study is a secondary analysis of the de-identified China Health and Retirement Longitudinal Study (CHARLS) public data. The original CHARLS was approved by the Ethical Review Committee of Peking University, and all participants signed the informed consent at the time of participation.

Competing interest

Lizheng Xu, Mingsheng Chen, Ke Peng, Mickael Hiligsmann, Stephen Jan, and Lei Si declare that they have no conflict of interest.

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Xu, L., Chen, M., Peng, K. et al. Socio-demographic disparities in health-related quality of life after hip fracture in China: evidence from the China Health and Retirement Longitudinal Study. Arch Osteoporos 18, 29 (2023). https://doi.org/10.1007/s11657-023-01220-2

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