Objective  To explore intermediary effect of health record establishment on the relationship between social support and health-related quality of life (HRQol) among elderly migrants in China for proving evidence to health risk control in the elderly.

  Methods  A face-to-face interview was conducted among 2 447 elderly migrants (aged ≥ 60 years and without local household registry) recruited with stratified multistage random sampling in 12 counties/districts of Beijing and Nanjing municipality during June – October 2021. The EuroQol Five-Dimensional Questionnaire (EQ-5D), the Social Support Rating Scale developed by domestic researchers, and a self-designed questionnaire were used in the survey. The impact of social support on the health utilities index among the elderly migrants was analyzed using a Tobit regression model, and the mediating role of the health record establishment on the relationship between social support and HRQol was examined using Monte Carlo test.

  Results   Complete information were collected from 2 057 elderly migrants. The participants′ health utilities index was 0.875 (25th percentile: 0.783, 75th percentile: 1.000). The results of Tobit regression revealed that objective support (β = 0.030), subjective support (β = 0.063), and establishment of health record (β = 0.034) were significant promotion factors for health utility (all P < 0.05) after adjusting for gender, age, nationality, household registration, education level, marital status, type of current or pre-retirement career, monthly average disposable income, number of children, housing type, time of migration, range of migration, reasons for migration, illness or physical discomfort in the past year, chronic disease, and medical insurance. The results of mediating effect analysis demonstrated that the indirect effect size of objective support on health utility was 0.017 (95% confidence interval 95%CI: 0.003 – 0.034) and the overall effect size was 0.047; the indirect effect size of subjective support on health utility was 0.019 (95%CI: 0.006 – 0.054) and the overall effect size was 0.082; and the indirect effect size of support utility on health utility was 0.028 (95%CI: 0.004 – 0.040) and the overall effect size was 0.028. The direct and indirect effect size accounted for 59.2% and 40.8% of overall effect size in the established model.

  Conclusion  Among the three dimensions of social support, subjective support exerts the greatest impact on elderly migrants' HRQol and the establishment of health record plays an intermediary role on the relationship between social support and HRQol in the population.