Health-related Quality of Life Measured Using the EQ-5D-3L and Health Service Utilization in Rural Residents of Ningxia

Background Exploring the factors affecting health service utilization is of great significance for optimizing the allocation of health services. Health-related quality of life (HRQoL) focuses on individuals' subjective self-assessment of their current health status, and may affect their health-seeking behaviors, but there are few studies on the impact of HRQoL on health service utilization of rural residents in China. Objective To explore the relationship between HRQoL and health service utilization of rural residents in Ningxia Hui Autonomous Region, and to provide a reference for the development of relevant policies/plans, and for the optimization health services in rural areas. Methods Data were collected from the Health Survey of Rural Residents Families 2019 conducted in four sample counties of Ningxia (Haiyuan, Pengyang, Xiji, Yanchi) from July to August 2019, involving 9 310 cases (≥15 years) with complete key information (gender, age, HRQoL-related indicators, health service utilization indicators). Detailed data of the residents were extracted, including socio-economic and demographic characteristics, health services accessibility, prevalence of chronic diseases, HRQoL measured using European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) and utilization of health services. The effects of health state utility values and visual analog scale (VAS) score on outpatient and inpatient health service utilization were analyzed by binary Logistic regression. Results The utilization rates of outpatient and inpatient health services of rural residents in Ningxia were 10.85% (1 010/9 310) and 18.86% (1 756/9 310), respectively. The mean health state utility values and mean VAS score of them were (0.965±0.090) and (69.97±17.84), respectively. Difference testing showed that residents with impaired self-care (in the EQ-5D-3L descriptive system) had higher rates of using outpatient health services〔OR (95%CI) =3.197 (2.633, 3.883), P