Objective To investigating the impact of Financial Burden on Health - Related Quality of Life in elderly patients with Chronic Comorbid Conditions and its mechanisms. Methods A convenience sample of 493 chronic comorbid patients was extracted from two community health service centers in Yanji City. General information was collected using a questionnaire, and the Patient Experiences with Primary Care (ASPC) scale, Comprehensive Score of Financial Burden (COST), Herth Hope Scale, and SF 一 36 Health Survey were utilized for the investigation. Univariate analysis, partial correlation analysis, and testing a moderated mediation model was conducted. Results (1) Financial Burden significantly predicted HRQoL (仔 二 0. 32, 95% C/:0. 24 - 0. 40, P <0. 001); (2) Hope level partially mediated the relationship between Financial Burden and HRQoL (仔二 0. 12, 95% C/:0. 08 - 0. 16, P < 0. 001), accounting for 37% of the total effect; (3) The direct predictive effect of Financial Burden on health 一 related quality of life (仔二 0. 07, 95% CI:0. 01 - 0. 14 <0. 05) and the mediating role of hope in their relationship (/3 = 0, 13,95% CI: 0. 05 - 0. 21, P < 0. 01) were both moderated by the core features of comprehensive primary care. Conclusion This study reveals the mechanism by which Financial Burden impacts HRQoL in elderly patients with chronic comorbidities. The findings emphasize the importance of enhancing economic support and hope levels for this patient group and highlight the role of comprehensive primary care function in mitigating the adverse effects of Financial Burden on HRQoL. These insights contribute to providing more comprehensive and effective medical services to patients with chronic comorbidities, alleviating the impact of Financial Burden, and enhancing their overall quality of life. [ABSTRACT FROM AUTHOR]