Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China

BackgroundThe aging process has led to a significant increase in the prevalence of somatic chronic diseases (e.g., cardiovascular diseases, diabetes) among the middle-aged and older adult population. Additionally, this demographic is also susceptible to mental disorders (e.g., depression, anxiety)....

Full description

Saved in:
Bibliographic Details
Main Authors: Mo Xue, Qianqian Zhang, Jialing Wu, Kan Tian
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1536205/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850153471563530240
author Mo Xue
Qianqian Zhang
Jialing Wu
Kan Tian
author_facet Mo Xue
Qianqian Zhang
Jialing Wu
Kan Tian
author_sort Mo Xue
collection DOAJ
description BackgroundThe aging process has led to a significant increase in the prevalence of somatic chronic diseases (e.g., cardiovascular diseases, diabetes) among the middle-aged and older adult population. Additionally, this demographic is also susceptible to mental disorders (e.g., depression, anxiety). However, most studies in China focus on somatic chronic disease comorbidities, with less attention on comorbidities between somatic and mental disorders, as well as health service utilization.PurposeTo investigate the factors influencing the comorbidities of somatic and somatic-mental disorder and the status of health service utilization among middle-aged and older adult individuals in China.MethodsData from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were analyzed, including 16,565 middle-aged and older adult individuals. Among them, 9,498 had somatic chronic disease comorbidities, and 4,577 had somatic-mental disorder comorbidities. Logistic regression was used to analyze factors influencing comorbidity and health service utilization. Spatial distribution maps were created using ArcGIS 10.8 software, and association rules were mined using IBM SPSS Modeler 18.0 and R 4.4.1.ResultsThe prevalence of somatic chronic disease comorbidity (57.34%) was higher than that of somatic-mental disorder comorbidity (27.63%). The patterns of comorbidity exhibited a complex network structure, with arthritis or rheumatism, hypertension, and stomach or other digestive disorders serving as core nodes. Dispositional factors (e.g., gender, age) and demand factors (e.g., number of comorbidities, self-rated health) had a significantly greater influence on the risk of comorbidities and health service utilization behaviors than enabling factors (e.g., household income, basic health insurance). Patients with somatic-mental disorder comorbidities had 1.09 times higher outpatient utilization compared to those with somatic chronic disease comorbidities (95% CI, 1.01 to 1.18). The average number of outpatient visits was also higher for the somatic-mental disorder comorbidities (2.55 ± 2.81 visits) than the somatic chronic disease comorbidities (2.34 ± 2.69 visits).ConclusionPay attention to the variations in the distribution of various combinations of comorbidity patterns within the population and develop targeted treatment strategies and preventive measures. Emphasize enhancing patients’ self-management skills and health literacy, also considering economic factors. Elevate the significance of mental health services and management, strengthen patients’ social support networks, and reduce social stigma and discrimination.
format Article
id doaj-art-d9c2a6fbd4d3418c921c02b96efe4942
institution OA Journals
issn 2296-2565
language English
publishDate 2025-04-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Public Health
spelling doaj-art-d9c2a6fbd4d3418c921c02b96efe49422025-08-20T02:25:43ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-04-011310.3389/fpubh.2025.15362051536205Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in ChinaMo Xue0Qianqian Zhang1Jialing Wu2Kan Tian3School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, ChinaSchool of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, ChinaSchool of Management, Lanzhou University, Lanzhou, ChinaSchool of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, ChinaBackgroundThe aging process has led to a significant increase in the prevalence of somatic chronic diseases (e.g., cardiovascular diseases, diabetes) among the middle-aged and older adult population. Additionally, this demographic is also susceptible to mental disorders (e.g., depression, anxiety). However, most studies in China focus on somatic chronic disease comorbidities, with less attention on comorbidities between somatic and mental disorders, as well as health service utilization.PurposeTo investigate the factors influencing the comorbidities of somatic and somatic-mental disorder and the status of health service utilization among middle-aged and older adult individuals in China.MethodsData from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were analyzed, including 16,565 middle-aged and older adult individuals. Among them, 9,498 had somatic chronic disease comorbidities, and 4,577 had somatic-mental disorder comorbidities. Logistic regression was used to analyze factors influencing comorbidity and health service utilization. Spatial distribution maps were created using ArcGIS 10.8 software, and association rules were mined using IBM SPSS Modeler 18.0 and R 4.4.1.ResultsThe prevalence of somatic chronic disease comorbidity (57.34%) was higher than that of somatic-mental disorder comorbidity (27.63%). The patterns of comorbidity exhibited a complex network structure, with arthritis or rheumatism, hypertension, and stomach or other digestive disorders serving as core nodes. Dispositional factors (e.g., gender, age) and demand factors (e.g., number of comorbidities, self-rated health) had a significantly greater influence on the risk of comorbidities and health service utilization behaviors than enabling factors (e.g., household income, basic health insurance). Patients with somatic-mental disorder comorbidities had 1.09 times higher outpatient utilization compared to those with somatic chronic disease comorbidities (95% CI, 1.01 to 1.18). The average number of outpatient visits was also higher for the somatic-mental disorder comorbidities (2.55 ± 2.81 visits) than the somatic chronic disease comorbidities (2.34 ± 2.69 visits).ConclusionPay attention to the variations in the distribution of various combinations of comorbidity patterns within the population and develop targeted treatment strategies and preventive measures. Emphasize enhancing patients’ self-management skills and health literacy, also considering economic factors. Elevate the significance of mental health services and management, strengthen patients’ social support networks, and reduce social stigma and discrimination.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1536205/fullsomatic chronic disease comorbiditysomatic-mental disorder comorbidityhealth service utilizationinfluencing factorsmiddle-agedolder adult people
spellingShingle Mo Xue
Qianqian Zhang
Jialing Wu
Kan Tian
Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China
Frontiers in Public Health
somatic chronic disease comorbidity
somatic-mental disorder comorbidity
health service utilization
influencing factors
middle-aged
older adult people
title Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China
title_full Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China
title_fullStr Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China
title_full_unstemmed Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China
title_short Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China
title_sort analysis of the current situation and factors influencing the utilization of somatic and somatic mental disorder comorbidity and health services among middle aged and older adult people in china
topic somatic chronic disease comorbidity
somatic-mental disorder comorbidity
health service utilization
influencing factors
middle-aged
older adult people
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1536205/full
work_keys_str_mv AT moxue analysisofthecurrentsituationandfactorsinfluencingtheutilizationofsomaticandsomaticmentaldisordercomorbidityandhealthservicesamongmiddleagedandolderadultpeopleinchina
AT qianqianzhang analysisofthecurrentsituationandfactorsinfluencingtheutilizationofsomaticandsomaticmentaldisordercomorbidityandhealthservicesamongmiddleagedandolderadultpeopleinchina
AT jialingwu analysisofthecurrentsituationandfactorsinfluencingtheutilizationofsomaticandsomaticmentaldisordercomorbidityandhealthservicesamongmiddleagedandolderadultpeopleinchina
AT kantian analysisofthecurrentsituationandfactorsinfluencingtheutilizationofsomaticandsomaticmentaldisordercomorbidityandhealthservicesamongmiddleagedandolderadultpeopleinchina