Background/Introduction: Undernutrition's impact on healthcare utilisation across age groups and care settings remains underexplored, particularly in Asian contexts. This study investigated the dynamic association between nutritional status and healthcare utilisation among community-dwelling adults in Singapore and assessed whether age modified this relationship. Methods: The study sampled 1703 adults enrolled in the Population Health Index study. Nutritional status was assessed annually using the Mini Nutritional Assessment, and healthcare utilisation data-across primary care, specialist outpatient clinics (SOCs), emergency departments (EDs), day surgeries, and inpatient admissions-were extracted from administrative databases. Negative binomial regressions with interaction terms using longitudinal panel data were conducted to examine age-modified effects. Results: At baseline, 9.7% of participants were classified as undernourished, with a higher prevalence in older adults (15.0%). Key risk factors for undernutrition included female sex, unemployment, financial inadequacy, currently smoking, lack of formal education, and multimorbidity. Undernutrition was associated with increased ED visits (IRR 1.41, AME: 0.35) and inpatient admissions (IRR 1.52, AME: 0.42). Among older adults, undernutrition was associated with less primary and specialist care (IRR: 0.72 and 0.57), while younger undernourished adults had more SOC visits (AME: 0.46). Older undernourished adults had 0.46 more ED visits and 0.47 more inpatient admissions on average in one year, though these increases did not differ from younger adults (interaction p > 0.05). Conclusions: Undernutrition is associated with increased ED visits and inpatient admissions, especially in older adults. Integrating nutritional screening and targeted interventions into community and primary care may help reduce preventable hospitalisations in high-risk populations.

Keywords: healthcare utilisation; longitudinal analysis; nutritional assessment; panel data; undernutrition.

背景/介绍：营养不良对各年龄段和不同医疗照护环境中的医疗服务利用的影响仍鲜有研究，尤其是在亚洲背景下。这项研究调查了新加坡社区居住成人中营养状况与医疗服务利用之间的动态关联，并评估年龄是否影响这种关系。方法：该研究抽取了1703名参加人口健康指数研究的成年人为样本。使用简易营养评估量表（Mini Nutritional Assessment）每年对受试者的营养状况进行评估，从行政数据库中提取包括初级保健、专科门诊诊所(SOCs)、急诊科(EDs)、日间手术和住院治疗在内的医疗服务利用数据。采用含有交互项的负二项回归纵向面板数据分析年龄调节效应。结果：基线时，9.7%的参与者被归类为营养不良，老年人中营养不良的发生率更高（15.0%）。营养不良的关键风险因素包括女性性别、失业、经济不足、目前吸烟、缺乏正式教育和多种慢性病。营养不良与急诊科就诊次数增加有关（IRR 1.41, AME: 0.35），以及住院治疗次数增多（IRR 1.52, AME: 0.42）。在老年人中，营养不良与较少的初级保健和专科护理相关联（IRR: 0.72 和 0.57），而在年轻且营养不良的人群中，则有更多专科门诊就诊（AME: 0.46）。老年营养不良者每年平均多出0.46次急诊科就诊和0.47次住院治疗，尽管这些增加在年轻人中也未表现出显著差异（交互作用p值 > 0.05）。结论：营养不良与急诊科就诊次数增加及住院治疗增多有关，尤其是在老年人群中。将营养筛查和有针对性的干预措施整合到社区和初级保健中，可能有助于减少高风险人群中的可预防性住院。

关键词：医疗服务利用；纵向分析；营养评估；面板数据；营养不良。