Introduction
Methods
Data source and participants
Measures
Family doctor contract services
Activities of daily living
Covariates
Statistical analysis
Results
Characteristics of the participants
Characteristic | N (%) | Family doctor contract services | P-value | |
---|---|---|---|---|
Yes (%) | No (%) | |||
Observations | 4249 | 2824 (66.46) | 1425 (33.54) | |
Age (years), mean (SD) | 67.73 (6.09) | 67.94 (5.98) | 67.32 (6.30) |
0.002
|
Gender | 0.398 | |||
Male | 1971 (46.39) | 1297 (45.93) | 674 (47.30) | |
Female | 2278 (53.61) | 1527 (54.07) | 751 (52.70) | |
Residence |
< 0.001
| |||
Urban | 2170 (51.07) | 1534 (54.32) | 636 (44.63) | |
Rural | 2079 (48.93) | 1290 (45.68) | 789 (55.37) | |
Education |
< 0.001
| |||
Illiterate | 1115 (26.24) | 805 (28.51) | 310 (21.75) | |
Primary school | 1381 (32.50) | 911 (32.26) | 470 (32.98) | |
Middle school | 1102 (25.94) | 688 (24.36) | 414 (29.05) | |
High school and above | 651 (15.32) | 420 (14.87) | 231 (16.21) | |
Marital status | 0.166 | |||
Single a | 568 (13.37) | 363 (12.85) | 205 (14.39) | |
Married | 3681 (86.63) | 2461 (87.15) | 1220 (85.61) | |
Household income b |
0.001
| |||
Q1 | 1319 (31.04) | 872 (30.88) | 447 (31.37) | |
Q2 | 806 (18.97) | 570 (20.18) | 236 (16.56) | |
Q3 | 1095 (25.77) | 742 (26.27) | 353 (24.77) | |
Q4 | 1029 (24.22) | 640 (22.66) | 389 (27.30) | |
Medical insurance |
< 0.001
| |||
Yes | 4204 (98.94) | 2807 (99.40) | 1397 (98.04) | |
No | 45 (1.06) | 17 (0.60) | 28 (1.96) | |
The time to the nearest clinic (minutes) | 0.492 | |||
≤ 10 | 3727 (87.71) | 2484 (87.96) | 1243 (87.23) | |
>10 | 522 (12.29) | 340 (12.04) | 182 (12.77) | |
Smoking |
< 0.001
| |||
Yes | 642 (15.11) | 384 (13.60) | 258 (18.11) | |
No | 3607 (84.89) | 2440 (86.40) | 1167 (81.89) | |
Drinking | 0.892 | |||
Yes | 1205 (28.36) | 799 (28.29) | 406 (28.49) | |
No | 3044 (71.64) | 2025 (71.71) | 1019 (71.51) | |
Self-rated health | 0.323 | |||
Very good | 1251 (29.44) | 809 (28.65) | 442 (31.02) | |
Good | 723 (17.02) | 501 (17.74) | 222 (15.58) | |
Fair | 1138 (26.78) | 754 (26.70) | 384 (26.95) | |
Poor | 667 (15.70) | 449 (15.90) | 218 (15.30) | |
Very poor | 470 (11.06) | 311 (11.01) | 159 (11.16) | |
Chronic health conditions |
< 0.001
| |||
No chronic condition | 1622 (38.17) | 1003 (35.52) | 619 (43.44) | |
One chronic condition | 1561 (36.74) | 1067 (37.78) | 494 (34.67) | |
Multimorbidity | 1066 (25.09) | 754 (26.70) | 312 (21.89) | |
Activities of daily living limitations |
0.006
| |||
Yes | 530 (12.47) | 380 (13.46) | 150 (10.53) | |
No | 3719 (87.53) | 2444 (86.54) | 1275 (89.47) |
Association between ADL limitations and family doctor contract services
Characteristics | Model 1a | Model 2b | Model 3c | |||
---|---|---|---|---|---|---|
OR (95% CI) | P-value | OR (95% CI) | P-value | OR (95% CI) | P-value | |
Main terms
| ||||||
ADL limitations (No Ref) | ||||||
Yes | 1.32 (1.08, 1.62) |
0.006
| 1.27 (1.02, 1.58) |
0.033
| 0.57 (0.29, 1.15) | 0.118 |
Residence (Urban Ref) | ||||||
Rural | 0.59 (0.51, 0.68) |
< 0.001
| 0.56 (0.48, 0.65) |
< 0.001
| ||
Interaction term
| ||||||
ADL limitations × Residence (Without ADL limitations × Urban Ref) | ||||||
ADL limitations × Rural | 1.64 (1.08, 2.48) |
0.020
| ||||
Controls
| ||||||
Age | 1.01 (1.00, 1.03) |
0.023
| 1.01 (1.00, 1.03) |
0.018
| ||
Gender (Male Ref) | ||||||
Female | 0.90 (0.76, 1.08) | 0.254 | 0.90 (0.77, 1.07) | 0.246 | ||
Education (Illiterate Ref) | ||||||
Primary school | 0.72 (0.60, 0.86) |
< 0.001
| 0.72 (0.60, 0.87) |
< 0.001
| ||
Middle school | 0.62 (0.50, 0.76) |
< 0.001
| 0.62 (0.50, 0.76) |
< 0.001
| ||
High school and above | 0.64 (0.50, 0.82) |
< 0.001
| 0.64 (0.50, 0.82) |
< 0.001
| ||
Marital status d (Single Ref) | ||||||
Married | 1.33 (1.09, 1.62) |
0.006
| 1.33 (1.09, 1.63) |
0.005
| ||
Household income e (Q1 Ref) | ||||||
Q2 | 1.21 (0.99, 1.47) | 0.063 | 1.20 (0.99, 1.47) | 0.066 | ||
Q3 | 1.01 (0.84, 1.22) | 0.902 | 1.01 (0.84, 1.21) | 0.931 | ||
Q4 | 0.70 (0.57, 0.86) |
0.001
| 0.70 (0.57, 0.85) |
< 0.001
| ||
Medical insurance (No Ref) | ||||||
Yes | 3.57 (1.93, 6.62) |
< 0.001
| 3.61 (1.94, 6.69) |
< 0.001
| ||
The time to the nearest clinic (minutes) (≤ 10 Ref) | ||||||
>10 | 0.88 (0.72, 1.07) | 0.203 | 0.88 (0.72, 1.07) | 0.200 | ||
Smoking (No Ref) | ||||||
Yes | 0.72 (0.59, 0.89) |
0.002
| 0.73 (0.60, 0.89) |
0.002
| ||
Drinking (No Ref) | ||||||
Yes | 1.13 (0.95, 1.35) | 0.173 | 1.13 (0.94, 1.35) | 0.186 | ||
Self-rated health (Very good Ref) | ||||||
Good | 1.40 (1.14, 1.72) |
0.001
| 1.40 (1.14, 1.73) |
0.001
| ||
Fair | 1.29 (1.07, 1.55) |
0.008
| 1.29 (1.08, 1.56) |
0.006
| ||
Poor | 1.46 (1.16, 1.81) |
0.001
| 1.45 (1.16, 1.80) |
0.001
| ||
Very poor | 1.43 (1.12, 1.82) |
0.004
| 1.43 (1.12, 1.82) |
0.004
| ||
Chronic health conditions (No chronic condition Ref) | ||||||
One chronic condition | 1.38 (1.18, 1.60) |
< 0.001
| 1.37 (1.18, 1.60) |
< 0.001
| ||
Multimorbidity | 1.57 (1.31, 1.88) |
< 0.001
| 1.57 (1.31, 1.88) |
< 0.001
|
Effect of residence on the association between ADL limitations and family doctor contract services
Variable | Urban (n = 2170) | Rural (n = 2079) | ||||||
---|---|---|---|---|---|---|---|---|
Model 1a | Model 2b | Model 1a | Model 2b | |||||
OR (95% CI) | P-value | OR (95% CI) | P-value | OR (95% CI) | P-value | OR (95% CI) | P-value | |
ADL limitations | ||||||||
No | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | ||||
Yes | 1.06 (0.78, 1.45) | 0.716 | 0.89 (0.63, 1.25) | 0.494 | 1.66 (1.28, 2.16) |
< 0.001
| 1.50 (1.13, 1.99) |
0.005
|