Patterns of Co-Occurrence of Chronic Disease Among Older Adults in Tokyo, Japan
Patterns of Co-Occurrence of Chronic Disease Among Older Adults in Tokyo, Japan
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DOI：
10.5888/pcd16.180170
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发表时间：
2019-01-01
影响因子：
5.5
通讯作者：
Ito, Hideki
中科院分区：
文献类型：
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作者：
Mitsutake, Seigo;Ishizaki, Tatsuro;Ito, Hideki
多发病是指患者同时发生2种或2种以上疾病，可能使治疗计划复杂化并影响健康结果。改善3种或3种以上慢性疾病并存患者的预防和管理策略需要了解常见3种疾病模式及其相互作用的流行病学。我们的研究旨在描述这些常见的3种疾病模式，并研究与老年日本patients.MethodsWe包括所有年龄在75岁或以上的日本公民在东京谁使用医疗保健2013年9月至2014年8月（N = 1，311，116）在我们的分析中共同发生的3种或多种疾病的相关因素。通过使用匿名医疗索赔数据库，根据性别和年龄从所有可能的组合中确定了22种目标疾病的15种最常见的3向模式。我们研究了协会的社会人口特征和医疗保健使用与存在的1或2个共同发生的疾病和3个或更多的共同发生的疾病，通过使用多项logistic regression. ResultsAbout 65%的患者有3个或更多的共同发生的疾病。最常见的三因素模式是男性高血压、冠心病和消化性溃疡病（12.4%），女性高血压、血脂异常和消化性溃疡病（12.8%）。3个或更多的疾病的患病率与男性，患者年龄在85至90岁，使用家庭医疗保健服务，门诊设施访问的数量，和hospitaladmission.ConclusionThe常见的3路疾病模式和多发病因素，在我们的研究中确定可能有助于识别高风险患者，并支持多发病的临床指南的发展。
IntroductionMultimorbidity, the co-occurrence of 2 or more disorders in a patient, can complicate treatment planning and affect health outcomes. Improvements in prevention and management strategies for patients with 3 or more or more co-occurring chronic diseases requires an understanding of the epidemiology of common 3-way disease patterns and their interactions. Our study aimed to describe these common 3-way disease patterns and examine the factors associated with the co-occurrence of 3 or more diseases in elderly Japanese patients.MethodsWe included all Japanese citizens aged 75 or older living in Tokyo who used medical care between September 2013 and August 2014 (N = 1,311,116) in our analysis. The 15 most common 3-way patterns of 22 target diseases according to sex and age were identified from among all possible combinations by using an anonymized medical claims database. We examined the associations of sociodemographic characteristics and health care use with the presence of 1 or 2 co-occurring diseases and 3 or more co-occurring diseases by using multinomial logistic regression.ResultsApproximately 65% of patients had 3 or more co-occurring diseases. The most common 3-way pattern was hypertension, coronary heart disease, and peptic ulcer disease in men (12.4%) and hypertension, dyslipidemia, and peptic ulcer disease in women (12.8%). The prevalence of 3 or more diseases was positively associated with men, patients aged 85 to 90, the use of home medical care services, the number of outpatient facilities visited, and hospital admissions.ConclusionThe common 3-way disease patterns and multimorbidity factors identified in our study may facilitate the recognition of high-risk patients and support the development of clinical guidelines for multimorbidity.