Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany.
Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany.
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DOI：
10.1186/1471-2458-11-101
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发表时间：
2011-02-14
影响因子：
4.5
通讯作者：
Schön G
中科院分区：
文献类型：
--
作者：
van den Bussche H;Koller D;Kolonko T;Hansen H;Wegscheider K;Glaeske G;von Leitner EC;Schäfer I;Schön G
在工业化国家，人们对多种疾病的兴趣日益浓厚。对于德国来说，越来越多的关注仍然与少数关于多重疾病的研究齐头并进。作者报告了对全国范围内经营的法定健康保险公司的大样本保单持有人（n = 123,224）进行横断面研究的第一个结果。这是第一项基于德国索赔数据针对多重疾病问题的综合研究。主要研究问题是找出哪些慢性病和疾病组合是老年人多发病所特有的。该研究基于所有 65 岁及以上投保人的索赔数据 (n = 123,224)。 2004 年对德国人口进行了年龄和性别调整。如果一个人在一年观察期内的三个或更多季度内至少诊断出 46 种慢性病列表中的 3 种，则该人被定义为多病患者。计算多病和非多病样本的患病率和风险比，以便识别针对多病更具体的诊断并检测多病模式的过度患病率。 62% 的样本患有多种疾病。在多病样本中，一般女性和因残疾而接受法定护理的患者所占比例过高。在三种慢性病可能的 15,180 种组合中，数据库中找到了 15,024 种（99%）。不管组合的种类繁多，最常见的个体慢性病也确实在组合中占主导地位：六种最常见的个体慢性病（高血压、脂质代谢紊乱、慢性腰痛、糖尿病、骨关节炎和慢性缺血性心脏病）的三联征涵盖了多病样本中 42% 的疾病谱。性别差异很小。当嘌呤/嘧啶代谢紊乱/痛风和骨关节炎是多种发病模式的一部分时，观察到的预期比率最高。上述主要慢性病及其组合的清单可以为制定与多发病相关的所需指南提供一个务实的开始。
Growing interest in multimorbidity is observable in industrialized countries. For Germany, the increasing attention still goes still hand in hand with a small number of studies on multimorbidity. The authors report the first results of a cross-sectional study on a large sample of policy holders (n = 123,224) of a statutory health insurance company operating nationwide. This is the first comprehensive study addressing multimorbidity on the basis of German claims data. The main research question was to find out which chronic diseases and disease combinations are specific to multimorbidity in the elderly. The study is based on the claims data of all insured policy holders aged 65 and older (n = 123,224). Adjustment for age and gender was performed for the German population in 2004. A person was defined as multimorbid if she/he had at least 3 diagnoses out of a list of 46 chronic conditions in three or more quarters within the one-year observation period. Prevalences and risk-ratios were calculated for the multimorbid and non-multimorbid samples in order to identify diagnoses more specific to multimorbidity and to detect excess prevalences of multimorbidity patterns. 62% of the sample was multimorbid. Women in general and patients receiving statutory nursing care due to disability are overrepresented in the multimorbid sample. Out of the possible 15,180 combinations of three chronic conditions, 15,024 (99%) were found in the database. Regardless of this wide variety of combinations, the most prevalent individual chronic conditions do also dominate the combinations: Triads of the six most prevalent individual chronic conditions (hypertension, lipid metabolism disorders, chronic low back pain, diabetes mellitus, osteoarthritis and chronic ischemic heart disease) span the disease spectrum of 42% of the multimorbid sample. Gender differences were minor. Observed-to-expected ratios were highest when purine/pyrimidine metabolism disorders/gout and osteoarthritis were part of the multimorbidity patterns. The above list of dominating chronic conditions and their combinations could present a pragmatic start for the development of needed guidelines related to multimorbidity.
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影响因子：
7.2
作者：
van den Akker, M;Buntinx, F;Knottnerus, JA
通讯作者：
Knottnerus, JA
DOI：
10.1093/gerona/62.3.286
发表时间：
2007-03-01
影响因子：
5.1
作者：
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通讯作者：
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影响因子：
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影响因子：
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作者：
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影响因子：
11.4
作者：
Britt, Helena C.;Harrison, Christopher M.;Knox, Stephanie A.
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