Health-related quality of life in poverty-alleviated individuals living with chronic conditions: a cross-sectional survey from an impoverished county in China

To investigate health-related quality of life (HRQoL) and its influencing factors among patients with chronic diseases in a rural population recently lifted out of poverty in China. In this cross-sectional study, 1,750 adults aged 15 years and older who had been lifted out of poverty were recruited from 23 rural townships in Linquan County, China. The HRQoL of the participants was evaluated using the 3-level version of the European quality of life five dimensions questionnaire (EQ-5D-3 L) questionnaire, and responses were converted to health utility score using the Chinese time trade-off value set. Regression analysis was conducted to examine the factors associated with overall HRQoL and its five health dimensions. Binary logistic regression analysis was conducted to examine the robustness of the results. The mean age of the 1,750 participants was (70.13$$\:\pm\:$$13.55) years. The average healthy utility score was (0.69$$\:\pm\:$$0.23). High proportions of participants reported problems in pain/discomfort (72%), anxiety/depression (54.91%), and mobility (51.38%). Female respondents reported more problems across all five EQ-5D dimensions than male. The Oaxaca-Blinder decomposition indicated that this disparity was driven primarily by differences in age and the number of chronic diseases. Tobit regression revealed that disability (β = -0.207, p<0.01), older age (β = -0.003, p < 0.01), and multimorbidity (β = -0.210, p < 0.01) were significantly associated with the reduction of HRQoL. Conversely, being married (β = 0.108, p < 0.01) and having a medium (β = 0.083, p < 0.01) or high income (β = 0.084, p < 0.01) were positively associated with HRQoL. The HRQoL among chronic disease patients in rural populations lifted out of poverty remains to be improved. From a societal perspective, the findings revealed remaining disparities rooted in age, sex, disability, income, and multimorbidity. Health policy must prioritize integrated, patient-centered approaches to consolidate poverty elimination achievements and advance health equity in the post-poverty era.