The increasing burden and complexity of multimorbidity.
The increasing burden and complexity of multimorbidity.
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多重疾病的负担和复杂性不断增加。
DOI：
10.1186/s12889-015-1733-2
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发表时间：
2015-04-23
影响因子：
4.5
通讯作者：
Wodchis WP
中科院分区：
文献类型：
--
作者：
Pefoyo AJ;Bronskill SE;Gruneir A;Calzavara A;Thavorn K;Petrosyan Y;Maxwell CJ;Bai Y;Wodchis WP
多发性硬化症是两种或两种以上慢性疾病的共同发生，在老年人中很常见，已知与高成本和护理质量差距有关。基于人口的多死亡率估计数不容易获得，这使得未来的规划成为一个挑战。我们的目的是估计在加拿大安大略的人口为基础的患病率和多发病的趋势，并检查慢性疾病的共同发生的模式。这项回顾性队列研究包括所有安大略省人（年龄在0至105岁之间），至少有16种常见慢性疾病之一。描述性统计被用来检查和比较2003年和2009年的年龄和疾病数量的多发性硬化症的患病率。还探讨了多发病个体中慢性疾病的共同发生。安大略人的多发病率从2003年的17.4%上升到2009年的24.3%，增加了40%。随着时间的推移，这种增长在所有年龄组都很明显。在个别慢性疾病中，多发病率为44%至99%。值得注意的是，没有共同发生条件的主导模式。多发性硬化症和多种疾病组合的高患病率表明，与以人为本的方法相比，单一的以疾病为导向的管理计划可能是高质量护理的有效性或效率较低的工具。本文的在线版本（doi：10.1186/s12889-015-1733-2）包含补充材料，可供授权用户使用。
Multimorbidity, the co-occurrence of two or more chronic conditions, is common among older adults and is known to be associated with high costs and gaps in quality of care. Population-based estimates of multimorbidity are not readily available, which makes future planning a challenge. We aimed to estimate the population-based prevalence and trends of multimorbidity in Ontario, Canada and to examine patterns in the co-occurrence of chronic conditions. This retrospective cohort study includes all Ontarians (aged 0 to 105 years) with at least one of 16 common chronic conditions. Descriptive statistics were used to examine and compare the prevalence of multimorbidity by age and number of conditions in 2003 and 2009. The co-occurrence of chronic conditions among individuals with multimorbidity was also explored. The prevalence of multimorbidity among Ontarians rose from 17.4% in 2003 to 24.3% in 2009, a 40% increase. This increase over time was evident across all age groups. Within individual chronic conditions, multimorbidity rates ranged from 44% to 99%. Remarkably, there were no dominant patterns of co-occurring conditions. The high prevalence of multimorbidity and numerous combinations of conditions suggests that single, disease-oriented management programs may be less effective or efficient tools for high quality care compared to person-centered approaches. The online version of this article (doi:10.1186/s12889-015-1733-2) contains supplementary material, which is available to authorized users.
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