Impact of multimorbidity: acute morbidity, area of residency and use of health services across the life span in a region of south Europe
| Autor: | Miguel Ángel Muñoz-Pérez, Quintí Foguet-Boreu, Jose M Valderas, Mariona Pons-Vigués, Concepció Violan, Enriqueta Pujol-Ribera, Teresa Rodriguez-Blanco, Albert Roso-Llorach |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Cross-sectional study Population Disease Comorbidity Chronic disease Young Adult Age Distribution Residence Characteristics Health care Medicine Humans Sex Distribution education Aged Acute disease Aged 80 and over education.field_of_study business.industry Incidence (epidemiology) Respiratory infection Multimorbidity Life-stage Health Services Middle Aged medicine.disease Cross-Sectional Studies Spain Female Rural area Family Practice business Demography Research Article |
| Zdroj: | BMC Family Practice |
| ISSN: | 1471-2296 |
| Popis: | BACKGROUND: Concurrent diseases, multiple pathologies and multimorbidity patterns are topics of increased interest as the world's population ages. To explore the impact of multimorbidity on affected patients and the consequences for health services, we designed a study to describe multimorbidity by sex and life-stage in a large population sample and to assess the association with acute morbidity, area of residency and use of health services. METHODS: A cross-sectional study was conducted in Catalonia (Spain). Participants were 1,749,710 patients aged 19+ years (251 primary care teams). PRIMARY OUTCOME: Multimorbidity (≥2 chronic diseases). Secondary outcome: Number of new events of each acute disease. Other variables: number of acute diseases per patient, sex, age group (19-24, 25-44, 45-64, 65-79, and 80+ years), urban/rural residence, and number of visits during 2010. RESULTS: Multimorbidity was present in 46.8% (95% CI, 46.7%-46.8%) of the sample, and increased as age increased, being higher in women and in rural areas. The most prevalent pair of chronic diseases was hypertension and lipid disorders in patients older than 45 years. Infections (mainly upper respiratory infection) were the most common acute diagnoses. In women, the highest significant RR of multimorbidity vs. non-multimorbidity was found for teeth/gum disease (aged 19-24) and acute upper respiratory infection. In men, this RR was only positive and significant for teeth/gum disease (aged 65-79). The adjusted analysis showed a strongly positive association with multimorbidity for the oldest women (80+ years) with acute diseases and women aged 65-79 with 3 or more acute diseases, compared to patients with no acute diseases (OR ranged from 1.16 to 1.99, p < 0.001). Living in a rural area was significantly associated with lower probability of having multimorbidity. The odds of multimorbidity increased sharply as the number of visits increased, reaching the highest probability in those aged 65-79 years. CONCLUSIONS: Multimorbidity is related to greater use of health care services and higher incidence of acute diseases, increasing the burden on primary care services. The differences related to sex and life-stage observed for multimorbidity and acute diseases suggest that further research on multimorbidity should be stratified according to these factors. |
| Databáze: | OpenAIRE |
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