What do we mean by multimorbidity? An analysis of the literature on multimorbidity measures, associated factors, and impact on health services organization
What do we mean by multimorbidity? An analysis of the literature on multimorbidity measures, associated factors, and impact on health services organization
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DOI：
10.1016/j.respe.2014.09.002
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发表时间：
2014-10-01
影响因子：
0.9
通讯作者：
Gagnayre, R.
中科院分区：
文献类型：
--
作者：
Lefevre, T.;d'Ivernois, J. -F.;Gagnayre, R.
背景。-多病是流行病学和人口转变的结果。与合并症不同，它目前没有一致的定义，因此难以评估其流行病学和社会经济负担，难以合理组织保健服务，也难以确定患者自力更生所需的技能。本研究的目的是定义多病的频谱，并讨论当前对护理组织的影响。-两名独立读者分析了PubMed、Embase、CINAHL和Scopus.Results索引的文献。- 2013年7月16日进行文献检索，共检索到2287篇（PubMed 670篇，Embase 666篇，Scopus 582篇，CINAHL 369篇）。其中108条保留。多重病态是由各种术语来定义的，它们都不是MeSH术语。多重疾病没有单一的衡量标准，因为这种疾病通常是研究其功能或经济影响，而不是其原因。根据所使用的测量方法和所研究的人群，患病率差异很大。与多重发病相关的因素是所研究人群的年龄、性别和社会经济特征。评估护理组织的研究是不确定的或不充分的。-多重疾病是现代医学和护理组织中反复出现的基本问题的化身。它可以根据其原因或后果来定义，并反映了我们对个人健康及其集体管理的概念。有工具可以更适当地衡量这一实体；我们应该利用它们将医疗现实与患者的需求相匹配。(C) 2014 Elsevier Masson SAS。版权所有。
Background. - Multimorbidity is a consequence of both epidemiological and demographic transition. Unlike comorbidity, it currently has no consensus definition, making it difficult to assess its epidemiological and socioeconomic burden, to organize healthcare services rationally, and to determine the skills needed for patient self-reliance. The aim of this study is to define the spectrum of multimorbidity and to discuss current implications for the organization of care.Methods. - Two independent readers analyzed the literature indexed in PubMed, Embase, CINAHL, and Scopus.Results. - The bibliographic search conducted on July 16, 2013, retrieved 2287 articles (670 in PubMed, 666 in Embase, 582 in Scopus, and 369 in CINAHL). Of these, 108 articles were retained. Multimorbidity is designated by a variety of terms, none of them being MeSH terms. There is no single measure of multimorbidity, as this entity is usually studied for its functional or economic impact, rather than its causes. The prevalence varies considerably, depending on the measure used and the population studied. Factors associated with multimorbidity are age, gender, and socioeconomic characteristics of the populations studied. Studies evaluating the organization-of-care are inconclusive or insufficient.Conclusions. - Multimorbidity serves as an avatar for the fundamental, recurrent problems of modern medicine and the organization-of-care. It may be defined by its causes or its consequences and reflects our concept of both individual health and its collective management. Tools that would allow a more appropriate measurement of this entity are available; we should use them to match medical reality to the needs of patients. (C) 2014 Elsevier Masson SAS. All rights reserved.