Table 2. Effect of the Association Between Physical Multimorbidity, Mental Health Conditions, and Socioeconomic Status on Health Service Use, HILDA Survey a , Australia, 2009, 2013, 2017.
| Characteristic | Number of GP Visits, IRR (95% CI)b | Number of Nights at Hospital, IRR (95% CI)b | Number of Prescription Medications, IRR (95% CI)b | Polypharmacy, AOR (95% CI)c | Excessive Polypharmacy, AOR (95% CI)d |
|---|---|---|---|---|---|
| Physical multimorbidity | 1.41 (1.39−1.43) | 1.77 (1.68−1.87) | 1.75 (1.72−1.78) | 2.77 (2.63−2.93) | 2.48 (2.25−2.73) |
| Mental health condition | 2.11 (2.03−2.20) | 3.59 (2.93−4.41) | 3.08 (2.92−3.25) | 4.61 (3.84−5.53) | 3.69 (2.46−5.53) |
| Physical health conditions × mental health conditionse | 0.86 (0.84−0.88) | 0.71 (0.65−0.78) | 0.73 (0.71−0.75) | 0.8 (0.73−0.87) | 0.86 (0.76−0.98) |
| Survey wave | |||||
| 9, 2009, n = 13,284 | Reference | ||||
| 13, 2013, n = 17 459 | 0.99 (0.97−1.02) | 1.05 (0.92−1.19) | Reference | ||
| 17, 2017, n = 17,527 | 0.99 (0.96−1.01) | 1.08 (0.95−1.23) | 1.06 (1.04−1.09) | 1.14 (1.05−1.23) | 1.06 (0.89, 1.26) |
| Socioeconomic indexes for areasf | |||||
| 5 | Reference | ||||
| 4 | 1.05 (1.01−1.09) | 0.96 (0.81−1.14) | 1 (0.94−1.05) | 0.99 (0.82−1.19) | 0.89 (0.58−1.37) |
| 3 | 1.08 (1.04−1.13) | 1.27 (1.06−1.52) | 1.02 (0.97−1.08) | 1.11 (0.92−1.33) | 0.9 (0.60, 1.36) |
| 2 | 1.18 (1.13−1.22) | 1.14 (0.96−1.36) | 1.11 (1.05−1.17) | 1.32 (1.11−1.58) | 1.3 (0.88−1.93) |
| 1 | 1.23 (1.19−1.29) | 1.37 (1.13−1.67) | 1.12 (1.05−1.18) | 1.33 (1.11−1.59) | 1.37 (0.93−2.01) |
| Sex | |||||
| Male | Reference | ||||
| Female | 1.41 (1.38−1.45) | 1.22 (1.08−1.37) | 1.2 (1.16−1.24) | 0.83 (0.74−0.92) | 0.78 (0.62−0.97) |
| Age | 1 (1.00−1.00) | 1.02 (1.01−1.02) | 1.03 (1.03−1.03) | 1.06 (1.05−1.06) | 1.04 (1.04−1.05) |
| Educationg | |||||
| Low | Reference | ||||
| Middle | 1 (0.97−1.03) | 0.95 (0.83−1.09) | 0.98 (0.94−1.02) | 0.84 (0.75−0.95) | 0.87 (0.68−1.10) |
| High | 0.88 (0.85−0.91) | 0.91 (0.77−1.06) | 0.95 (0.90−1.00) | 0.66 (0.56−0.78) | 0.68 (0.47−1.00) |
| Indigenous status | |||||
| Non-Indigenous Australian | Reference | ||||
| Indigenous Australian | 1.11 (1.02−1.20) | 1.67 (1.19−2.34) | 1.01 (0.91−1.11) | 1.32 (0.97−1.79) | 1.03 (0.56−1.90) |
| Country of birth | |||||
| Australia | Reference | ||||
| Other English-speaking country (United Kingdom, New Zealand, Canada, United States, Ireland, or South Africa) | 0.96 (0.91−1.00) | 0.82 (0.68−0.98) | 0.94 (0.89−0.99) | 0.99 (0.84−1.16) | 0.99 (0.72−1.36) |
| All others | 1.06 (1.02−1.11) | 0.82 (0.65−1.04) | 0.82 (0.78−0.86) | 0.83 (0.71−0.98) | 0.7 (0.50−0.99) |
| Marital status | |||||
| Married/cohabiting | Reference | ||||
| Single, separated, divorced, or widowed | 1.0 (0.97−1.02) | 1.24 (1.10−1.39) | 1.03 (1.00−1.07) | 1.07 (0.96−1.20) | 1.34 (1.08−1.66) |
| State | |||||
| New South Wales | Reference | ||||
| Victoria | 1.03 (0.99−1.06) | 0.97 (0.82−1.14) | 1.01 (0.97−1.06) | 1.07 (0.93−1.24) | 1.2 (0.89−1.62) |
| Queensland | 1.02 (0.98−1.05) | 1.03 (0.88−1.20) | 1.03 (0.98−1.08) | 1.13 (0.97−1.31) | 1.36 (1.01−1.83) |
| South Australia | 1.0 (0.95−1.05) | 0.95 (0.78−1.16) | 1.08 (1.02−1.15) | 1.24 (1.02−1.50) | 1.47 (1.02−2.11) |
| Western Australia | 0.95 (0.91−1.00) | 0.99 (0.81−1.21) | 1.06 (0.99−1.13) | 1.18 (0.96−1.44) | 1.27 (0.86−1.89) |
| Tasmania | 0.96 (0.89−1.04) | 0.77 (0.60−0.99) | 1.05 (0.96−1.16) | 0.92 (0.67−1.26) | 0.85 (0.47−1.53) |
| Northern Territory | 0.88 (0.76−1.01) | 1.14 (0.74−1.76) | 0.95 (0.73−1.23) | 0.71 (0.27−1.90) | NA |
| Australian Capital Territory | 0.96 (0.88−1.05) | 1.03 (0.68−1.55) | 0.96 (0.84−1.09) | 0.97 (0.62−1.51) | 1.67 (0.67−4.18) |
| Area | |||||
| Urban | Reference | ||||
| Rural | 0.95 (0.91−0.99) | 1.01 (0.86−1.18) | 0.97 (0.93−1.02) | 0.97 (0.84−1.13) | 0.88 (0.64−1.22) |
Abbreviations: AOR, adjusted odds ratio; GP, general practitioner; HILDA, Household, Income and Labour Dynamics in Australia Survey; IRR, incidence rate ratio; NA, not applicable.
A nationally representative longitudinal survey that collects key information on economic and personal well-being, labor market dynamics, and family life in Australian households among individuals aged 15 years or over (16).
Number of GP visits, nights at hospital, and prescription medications calculated by using generalized estimating equations with negative binomial family.
Taking 5 or more prescription medications, calculated by using generalized estimating equations with binomial family.
Taking 10 or more prescription medications, calculated by using generalized estimating equations with binomial family.
Physical and mental condition interaction: number of physical conditions and the presence of mental health conditions (binary).
Scale of 1 to 5 with 5 the highest. Socio Economic Indexes for Areas (SEIFA) is an index that ranks geographic areas across Australia according to relative socioeconomic advantage and disadvantage. SEIFA was created on the basis of 2011 social and economic census information.
Low level (year11 and below), middle level (year 12, certificate ⅲ or ⅳ, diploma, advanced diploma), high level (bachelor or honors, graduate diploma, graduate certificate, post graduate).