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多重疾病的当前及预计负担:一项针对南欧人群的横断面研究

The current and projected burden of multimorbidity: a cross-sectional study in a Southern Europe population.

作者信息

Laires P A, Perelman J

机构信息

1Centro de Investigação em Saúde Pública (CISP), Escola Nacional de Saúde Pública (ENSP), Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal.

2Escola Nacional de Saúde Pública (ENSP), Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal.

出版信息

Eur J Ageing. 2018 Sep 1;16(2):181-192. doi: 10.1007/s10433-018-0485-0. eCollection 2019 Jun.

Abstract

In a context of increasing ageing of the population, it is crucial to better understand multimorbidity and its consequences. This study measured the prevalence of multimorbidity in a Southern Europe population and projected its evolution based on expected demographic changes. It also analysed its associated consequences on self-reported health status, functional capacity, and healthcare use. Our sample included all people aged 25-79 years (6679 men and 8517 women) who participated in the fifth Portuguese National Health Interview Survey, conducted in 2014. Multimorbidity was measured by the presence of at least two self-reported chronic conditions. Multivariable regressions were used to assess the association of multimorbidity with health status, functional capacity, and healthcare use. The projected evolution of multimorbidity was based on official demographic projections. 43.9% of the Portuguese population self-reported the multimorbidity, which was more frequent among older people, women, and low-educated people. We found an association of multimorbidity with poorer health status (OR 3.32, 95%CI 2.60-4.24) and with limited functional capacity (OR 4.44, 95%CI 3.85-5.11). Multimorbidity was also associated with higher healthcare resource use, namely a 26% increased likelihood of hospitalization in the previous 12 months per additional comorbidity. We projected a 13.1% growth in the prevalence of multimorbidity until the year 2050. Multimorbidity affects a substantial share of the population and is expected to grow in the near future related to population ageing. The co-occurrence of chronic health conditions increases sharply with age and is associated with worse health status, reduced functional capacity, and increased healthcare use.

摘要

在人口老龄化加剧的背景下,更好地了解多重疾病及其后果至关重要。本研究测量了南欧人群中多重疾病的患病率,并根据预期的人口变化预测了其演变。研究还分析了多重疾病对自我报告的健康状况、功能能力和医疗保健使用的相关影响。我们的样本包括所有年龄在25至79岁之间(6679名男性和8517名女性)且参与了2014年进行的第五次葡萄牙全国健康访谈调查的人。多重疾病通过至少两种自我报告的慢性病的存在来衡量。使用多变量回归来评估多重疾病与健康状况、功能能力和医疗保健使用之间的关联。多重疾病的预测演变基于官方人口预测。43.9%的葡萄牙人口自我报告患有多重疾病,在老年人、女性和低学历人群中更为常见。我们发现多重疾病与较差的健康状况(比值比3.32,95%置信区间2.60 - 4.24)以及有限的功能能力(比值比4.44,95%置信区间3.85 - 5.11)相关。多重疾病还与更高的医疗资源使用相关,即每增加一种合并症,在过去12个月内住院的可能性增加26%。我们预测到2050年多重疾病的患病率将增长13.1%。多重疾病影响了相当一部分人口,并且预计在不久的将来会随着人口老龄化而增加。慢性健康状况的共存随着年龄的增长急剧增加,并与更差的健康状况、功能能力下降和医疗保健使用增加相关。

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