Department of preventive medicine, School of Medicine, Ewha Womans University, Seoul, South Korea.
Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
Health Qual Life Outcomes. 2018 Sep 15;16(1):186. doi: 10.1186/s12955-018-1016-6.
Multimorbidity negatively affects health outcomes and impairs health-related quality of life (HRQoL). We assessed the prevalence of multimorbidity in Koreans aged 50 and older, taking into consideration their socioeconomic status, and estimated the loss in HRQoL due to multimorbidity.
This study is based on an analysis of data for adults aged 50 and older derived from the cross-sectional nationally representative Korean National Health and Nutrition Examination Survey conducted in 2013-14. The five most prevalent chronic diseases and disease dyads were identified. The impact of the degree of multimorbidity, sex, and socioeconomic status on the European Quality of Life 5 Dimension (EQ-5D) index score were analyzed. Marital status, educational attainment, household income, basic livelihood security benefit, and occupation were considered as socioeconomic factors.
The analysis included 5996 adults aged 50 years and older with males comprising 46.6%. Two or more chronic diseases were present in 26.8% of the participants aged 50 and older and 37.9% of the participants aged 65 and older. The most prevalent dyadic combination was hypertension and dyslipidemia in the 50 and older group, and hypertension and osteoarthritis in the 65 and older age group. Hypertension dominated the multimorbidity combinations (four of the five most prevalent multimorbidity dyads), while a few conditions such as osteoarthritis had a relatively large influence on quality of life. In addition to the degree of multimorbidity, female and lower socioeconomic status were associated with significantly lower EQ-5D index scores.
Integrated, holistic healthcare based on a patient-oriented perspective for earlier, more effective intervention, targeting multimorbidity is warranted. Special consideration should be given to patients with low socioeconomic status.
多种疾病对健康结果产生负面影响,并损害与健康相关的生活质量(HRQoL)。我们评估了考虑到社会经济地位的 50 岁及以上韩国人多种疾病的患病率,并估计了多种疾病导致的 HRQoL 损失。
本研究基于对 2013-14 年进行的全国代表性韩国国家健康和营养检查调查中 50 岁及以上成年人数据的分析。确定了五种最常见的慢性疾病和疾病对偶。分析了多种疾病的严重程度、性别和社会经济地位对欧洲生活质量 5 维度(EQ-5D)指数评分的影响。婚姻状况、教育程度、家庭收入、基本生计保障福利和职业被视为社会经济因素。
分析包括 5996 名 50 岁及以上的成年人,其中男性占 46.6%。26.8%的 50 岁及以上参与者和 37.9%的 65 岁及以上参与者存在两种或多种慢性疾病。最常见的对偶组合是 50 岁及以上组的高血压和血脂异常,以及 65 岁及以上组的高血压和骨关节炎。高血压在多种疾病组合中占主导地位(五种最常见的多种疾病对偶中的四种),而一些疾病,如骨关节炎,对生活质量的影响相对较大。除了多种疾病的严重程度外,女性和较低的社会经济地位与 EQ-5D 指数评分显著降低相关。
需要基于以患者为中心的观点,为早期、更有效的干预提供综合、整体的医疗保健,针对多种疾病。应特别关注社会经济地位较低的患者。