1Korea Armed Forces Nursing Academy, Daejeon, Korea.
2Department of Nursing, Changwon National University, Changwon, Korea.
© 2016 Korean Academy of Community Health Nursing
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
NHI=national health insurance; NMC=not included musculoskeletal condition; †Missing data excluded.
Dependent variable : health-related quality of life (EQ-5D index)
Note. Predictors : (constant), gender, educational level, annual income of household (million won), occupational type, smoking, drinking, moderate physical activity, type of health insurance, number of chronic disease, type of multimorbidity, unmet healthcare needs.
| Combination of multimorbidity | Total | Young and middle-aged adults | Older adults | ||
|---|---|---|---|---|---|
| 1st Disease | 2nd Disease | 3rd Disease | n (%) | n (%) | n (%) |
| Hypertension | Diabetes | Hyperlipidemia | 263 (26.1) | 63 (33.2) | 200 (24.5) |
| Hypertension | Diabetes | Arthritis | 178 (17.7) | 14 (7.4) | 164 (20.1) |
| Hypertension | Hyperlipidemia | Arthritis | 173 (17.2) | 28 (14.7) | 145 (17.8) |
| Hypertension | Arthritis | Lumbar pain | 34 (3.4) | 2 (1.1) | 32 (3.9) |
| Hypertension | Hyperlipidemia | Angina | 33 (3.3) | 10 (5.3) | 23 (2.8) |
| Hypertension | Arthritis | Angina | 29 (2.9) | 1 (0.5) | 28 (3.4) |
| Hypertension | Arthritis | Osteoporosis | 28 (2.8) | 1 (0.5) | 27 (3.3) |
| Hypertension | Diabetes | Angina | 25 (2.5) | 9 (4.7) | 16 (2.0) |
| Hypertension | Arthritis | Disc herniation | 24 (2.4) | 6 (3.2) | 18 (2.2) |
| Diabetes | Hyperlipidemia | Arthritis | 21 (2.1) | 9 (4.7) | 12 (1.5) |
| Hypertension | Hyperlipidemia | Crebral infarction | 18 (1.8) | 5 (2.6) | 13 (1.6) |
| Hypertension | Diabetes | Stroke | 17 (1.7) | 1 (0.5) | 16 (2.0) |
| Hypertension | Arthritis | Stroke | 15 (1.5) | 0 (0.0) | 15 (1.8) |
| Hypertension | Diabetes | Lumbar pain | 13 (1.3) | 1 (0.5) | 12 (1.5) |
| Hypertension | Hyperlipidemia | Spinal stenosis | 13 (1.3) | 5 (2.6) | 8 (1.0) |
| Hypertension | Diabetes | Crebral infarction | 12 (1.2) | 2 (1.1) | 10 (1.2) |
| Hypertension | Diabetes | Disc herniation | 12 (1.2) | 3 (1.6) | 9 (1.1) |
| Hypertension | Hyperlipidemia | Gout | 12 (1.2) | 5 (2.6) | 7 (0.9) |
| Hypertension | Hyperlipidemia | Disc herniation | 12 (1.2) | 8 (4.2) | 4 (0.5) |
| Hypertension | Hyperlipidemia | Osteoporosis | 12 (1.2) | 1 (0.5) | 11 (1.3) |
| Hypertension | Arthritis | Crebral infarction | 12 (1.2) | 3 (1.6) | 9 (1.1) |
| Hypertension | Hyperlipidemia | Allergic rhinitis | 10 (1.0) | 8 (4.2) | 2 (0.2) |
| Hypertension | Hyperlipidemia | Rheumatoid arthritis | 10 (1.0) | 2 (1.1) | 8 (1.0) |
| Hypertension | Arthritis | Ischemic heart disease | 10 (1.0) | 0 (0.0) | 10 (1.2) |
| Hypertension | Arthritis | Spinal stenosis | 10 (1.0) | 0 (0.0) | 10 (1.2) |
| Hypertension | Arthritis | Frozen shoulder | 10 (1.0) | 3 (1.6) | 7 (0.9) |
| Total | 1,006 (100.0) | 190 (100.0) | 816 (100.0) | ||
| Characteristics | Categories | Total (N=1,006) | Young and middle-aged adults (N=190) | Older adults (N=816) |
|---|---|---|---|---|
| n (%) or M±SD | n (%) or M±SD | n (%) or M±SD | ||
| Age (year) | 71.99±8.87 | 58.00±5.24 | 75.25±5.86 | |
| Gender | Male | 289 (28.7) | 73 (38.4) | 216 (26.5) |
| Female | 717 (71.3) | 117 (61.6) | 600 (73.5) | |
| Educational level | ≤Middle school | 743 (73.9) | 98 (51.6) | 645 (79.0) |
| High school | 186 (18.5) | 61 (32.1) | 125 (15.3) | |
| ≥Bachelors | 77 (7.7) | 31 (16.3) | 46 (5.6) | |
| Annual income of household (million won) | 27.03±31.73 | 43.29±52.40 | 23.25±23.00 | |
| 1 quintile (bottom 20%) | 374 (37.2) | 33 (17.4) | 341 (41.8) | |
| 2 quintile (20~40%) | 245 (24.4) | 31 (16.3) | 214 (26.2) | |
| 3 quintile (40~60%) | 175 (17.4) | 44 (23.2) | 131 (16.1) | |
| 4 quintile (60~80%) | 123 (12.2) | 46 (24.2) | 77 (9.4) | |
| 5 quintile (above 80%) | 88 (8.8) | 36 (18.9) | 52 (6.4) | |
| Religion | Seoul | 136 (13.5) | 29 (15.3) | 107 (13.1) |
| Metropolitan city | 249 (24.8) | 49 (25.8) | 200 (24.5) | |
| Province | 621 (61.7) | 112 (58.9) | 509 (62.4) | |
| Occupational type | Unemployed | 681 (67.7) | 75 (39.5) | 606 (74.3) |
| Paid worker | 141 (14.0) | 73 (38.4) | 68 (8.3) | |
| Businessman, self-employed | 118 (11.7) | 29 (15.3) | 89 (10.9) | |
| Unpaid family worker | 66 (6.6) | 13 (6.8) | 53 (6.5) | |
| Smoking | Never smoke | 704 (71.5) | 123 (66.1) | 581 (72.8) |
| Former smoker/current nonsmoker | 182 (18.5) | 34 (18.3) | 148 (18.5) | |
| Current smoker | 98 (10.0) | 29 (15.6) | 69 (8.6) | |
| Drinking | Non drinker | 590 (60.0) | 71 (38.2) | 519 (65.0) |
| Moderate drinker | 293 (29.8) | 67 (36.0) | 226 (28.3) | |
| Heavy drinker | 101 (10.3) | 48 (25.8) | 53 (6.6) | |
| Moderate physical activity | <3 times a week | 721 (73.3) | 119 (64.0) | 602 (75.4) |
| ≥3 times a week | 263 (26.7) | 67 (36.0) | 196 (24.6) | |
| Type of health insurance | National health insurance | 911 (90.6) | 171 (90.0) | 740 (90.7) |
| Medical care assistance | 95 (9.4) | 19 (10.0) | 76 (9.3) | |
| Number of chronic disease | 5.75±2.29 | 5.03±2.12 | 5.92±2.30 | |
| 3~6 | 692 (68.8) | 153 (80.5) | 539 (66.1) | |
| 7~9 | 242 (24.1) | 29 (15.3) | 213 (26.1) | |
| ≥10 | 72 (7.2) | 8 (4.2) | 64 (7.8) | |
| Type of multimorbidity | Not included musculoskeletal condition | 378 (37.6) | 98 (51.6) | 280 (34.3) |
| Included musculoskeletal condition | 628 (62.4) | 92 (48.4) | 536 (65.7) | |
| Unmet healthcare needs | Unmet healthcare needs | 217 (22.1) | 44 (23.7) | 173 (21.7) |
| Not unmet healthcare needs | 767 (77.9) | 142 (76.3) | 625 (78.3) |
| Characteristics | Young and middle-aged adults (N=190) | Older adults (N=816) | |||
|---|---|---|---|---|---|
| M±SD | t or F (p) | M±SD | t or F (p) | ||
| HRQOL | 0.87±0.12 | 0.84±0.12 | 3.30‡ (.001) | ||
| Gender | Male | 0.87±0.15 | −0.27 (.791) | 0.88±0.09 | 6.99 (<.001) |
| Female | 0.87±0.09 | 0.82±0.13 | |||
| Educational level | ≤Middle schoola | 0.87±0.11 | 4.21 (.016) a, b<c |
0.83±0.12 | 11.75 (<.001) a<b, c |
| High schoolb | 0.85±0.15 | 0.87±0.10 | |||
| ≥Bachelorsc | 0.92±0.05 | 0.88±0.09 | |||
| Annual income of household (million won) | 1 quintile (bottom 20%)a | 0.80±0.14 | 4.59 (.001) a<e |
0.82±0.13 | 2.97 (.019) a<d |
| 2 quintile (20~40%)b | 0.88±0.12 | 0.84±0.12 | |||
| 3 quintile (40~60%)c | 0.88±0.08 | 0.85±0.12 | |||
| 4 quintile (60~80%)d | 0.86±0.14 | 0.86±0.11 | |||
| 5 quintile (above 80%)e | 0.92±0.05 | 0.86±0.11 | |||
| Religion | Seoul | 0.88±0.08 | 0.24 (.789) | 0.85±0.11 | 0.90 (.408) |
| Metropolitan city | 0.87±0.11 | 0.83±0.13 | |||
| Province | 0.87±0.13 | 0.84±0.12 | |||
| Occupational type | Unemployeda | 0.84±0.16 | 2.20 (.090) | 0.82±0.13 | 10.98 (<.001) a<b, c b>d |
| Paid workerb | 0.89±0.08 | 0.89±0.07 | |||
| Businessman, self-employedc | 0.89±0.08 | 0.88±0.09 | |||
| Unpaid family workerd | 0.88±0.10 | 0.85±0.09 | |||
| Smoking | Never smokea | 0.88±0.09 | 1.18 (.311) | 0.83±0.13 | 5.83 (.003) a<b |
| Former smoker/current nonsmokerb | 0.85±0.18 | 0.86±0.10 | |||
| Current smokerc | 0.85±0.13 | 0.85±0.11 | |||
| Drinking | Non drinkera | 0.85±0.14 | 2.59 (.078) | 0.82±0.13 | 16.45 (<.001) a<b, c |
| Moderate drinkerb | 0.88±0.11 | 0.86±0.09 | |||
| Heavy drinkerc | 0.89±0.09 | 0.89±0.08 | |||
| Moderate physical activity | <3 times a week | 0.86±0.13 | −2.17 (.031) | 0.83±0.13 | −5.65 (<.001) |
| ≥3 times a week | 0.89±0.08 | 0.87±0.09 | |||
| Type of health insurance | National health insurance | 0.88±0.11 | 2.69 (.015) | 0.84±0.12 | 3.34 (.001) |
| Medical care assistance | 0.77±0.16 | 0.79±0.11 | |||
| Number of chronic disease | 3~6a | 0.89±0.11 | 9.50 (<.001) a>b>c |
0.85±0.10 | 30.45 (<.001) a>b>c |
| 7~9b | 0.82±0.14 | 0.82±0.12 | |||
| ≥10c | 0.75±0.11 | 0.74±0.20 | |||
| Type of multimorbidity | Not included musculoskeletal condition | 0.86±0.14 | −1.05 (.297) | 0.86±0.13 | 3.68 (<.001) |
| Included musculoskeletal condition | 0.88±0.08 | 0.83±0.12 | |||
| Unmet healthcare needs | Unmet healthcare needs | 0.86±0.13 | −0.90 (.369) | 0.79±0.13 | −6.33 (<.001) |
| Not unmet healthcare needs | 0.88±0.11 | 0.85±0.11 | |||
| Variables | Model 1 | Model 2 | ||||
|---|---|---|---|---|---|---|
| Young and middle-aged adults (n=190) | Older adults (n=816) | |||||
| B | t | p | B | t | p | |
| Female (Male=0) | 0.01 | 0.42 | .676 | −0.02 | −1.23 | .220 |
| Education (Below middle school=0) | ||||||
| High school | 0.00 | −0.14 | .888 | 0.03 | 2.68 | .008 |
| ≥Bachelors | 0.07 | 2.58 | .011 | 0.03 | 1.53 | .126 |
| Annual income of household (million won) | 0.35 | 0.21 | .831 | −0.30 | −0.16 | .873 |
| Occupational type (Paid worker=0) | ||||||
| Unemployed | 0.00 | −0.21 | .830 | −0.04 | −2.72 | .007 |
| Businessman/self-employed | 0.01 | 0.48 | .633 | −0.01 | −0.66 | .507 |
| Unpaid family worker | −0.02 | −0.45 | .657 | −0.02 | −1.00 | .320 |
| Smoking (Never smoke=0) | ||||||
| Former smoker/current nonsmoker | −0.05 | −1.66 | .100 | −0.01 | −0.39 | .694 |
| Current smoker | −0.07 | −2.19 | .030 | −0.01 | −0.69 | .488 |
| Drinking (Non drinker=0) | ||||||
| Moderate drinker | 0.02 | 1.01 | .314 | 0.03 | 3.07 | .002 |
| Heavy drinker | 0.05 | 2.04 | .043 | 0.02 | 1.01 | .315 |
| Moderate physical activity (<3 times a week=0) | ||||||
| More than 3 times a week | 0.02 | 0.91 | .362 | 0.02 | 2.45 | .015 |
| Type of health insurance (NHI=0) | ||||||
| Medical care assistance | −0.04 | −1.35 | .180 | −0.01 | −0.71 | .476 |
| Number of chronic disease | −0.01 | −3.66 | <.001 | −0.01 | −6.35 | <.001 |
| Type of multimorbidity (NMC=0) | ||||||
| Included musculoskeletal condition | 0.01 | 0.56 | .575 | −0.03 | −3.08 | .002 |
| Unmet healthcare needs (Yes=0) | ||||||
| Not unmet healthcare needs | 0.01 | 0.31 | .754 | 0.05 | 5.15 | <.001 |
| R2=.24, Adj. R2=.17, F=3.30, p<.001 R2=.19, Adj. R2=.17, F=11.33, p<.001 | ||||||
† Missing data excluded.
HRQOL=health-related quality of life; †Missing data excluded; ‡Result of indepent t-test between young and middle-aged, and older adult.
NHI=national health insurance; NMC=not included musculoskeletal condition; †Missing data excluded. Dependent variable : health-related quality of life (EQ-5D index) Note. Predictors : (constant), gender, educational level, annual income of household (million won), occupational type, smoking, drinking, moderate physical activity, type of health insurance, number of chronic disease, type of multimorbidity, unmet healthcare needs.