Abstract: Background Under the strategy of prioritizing health development, where health is regarded as a key indicator of modernization and a happy life, improving the health-related quality of life (HRQoL) of rural elderly individuals, particularly those with multiple chronic diseases, embodies the principle of people-centered development. However, the specific livelihood capital that impacts the HRQoL of rural elderly individuals remains unclear. Objective By evaluating the quality of life of rural elderly and analyzing the impact of livelihood capital, advice is provided to improve HRQOL.Methods Using survey data from July to August 2023 in Zhejiang, Chongqing, and Gansu provinces,the EQ-5D-3L scale was used to survey rural elderly aged 60 and above,and multi-level linear regression analysis was conducted to analyze influencing factors.Results the HRQOL of populations without chronic diseases,with single chronic diseases,and with multiple chronic diseases were 0.91±0.13,0.87±0.16,and 0.80±0.19.In the population without chronic diseases, differences in human capital,digital capital,and psychological capital had statistical significance (P<0.05).the single chronic diseases,differences in social capital,human capital,digital capital,and psychological capital had statistical significance (P<0.05) with their health utility values.the multiple chronic diseases,differences in social capital, financial capital,digital capital,and psychological capital had statistical significance (P<0.05).Conclusion HRQOL decreases with the increase of the number of chronic diseases.It is necessary to explore and utilize the advantages of livelihood capital to improve the HRQOL of rural elderly.

Key words: Multiple chronic diseases, Livelihood Capital, Quality of life, Rural elderly

摘要： 背景 健康优先发展战略下，健康作为现代化、幸福生活的最重要指标，提升农村老年人尤其是多重慢病人群健康生命质量是以人民为中心发展思想的体现，但影响农村老年人生命质量的具体生计资本尚未明确。目的 通过评价不同类别农村老年生命质量现状并分析生计资本带来的影响，为改善其生命质量提供有关建议。方法 采用2023年7-8月课题组于浙江、重庆、甘肃三省（市）入户调研数据，使用EQ-5D-3L量表对60岁及以上农村老人调查，采用多元线性回归分析影响因素。结果 无慢病、单一慢病、多重慢病人群健康效用值分别为0.91±0.13、0.87±0.16、0.80±0.19。其中，无慢病人群中，人力资本、数字资本、心理资本与健康效用值差异具有统计学意义(P<0.05)。单一慢病人群中，社会、人力、数字、心理等资本与健康效用值差异具有统计学意义(P<0.05)。多重慢病人群中，社会、金融、数字、心理等资本与健康效用值差异具有统计学意义(P<0.05)。结论 农村老年健康效用值得分随慢病数量增加呈现下降趋势。生计资本会对各群体健康生命质量产生一定影响，建议综合考虑多维资本，发掘并利用其优势来改善农村老年生命质量。

关键词: 多重慢病, 生计资本, 生命质量, 农村老年人