Comparisons of multi-morbidity in family practiceuissues and biases
Comparisons of multi-morbidity in family practiceuissues and biases
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DOI：
10.1093/fampra/cmt012
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发表时间：
2013-08-01
期刊：
影响因子：
2.2
通讯作者：
Maddocks, Heather L.
中科院分区：
文献类型：
--
作者：
Stewart, Moira;Fortin, Martin;Maddocks, Heather L.
随着人口老龄化，实践和政策需要指导的准确估计慢性疾病负担在primary care.To产生一套初步的方法学考虑的横断面和回顾性队列研究的多发病率在初级care. To使用三个研究为例。我们比较了三项独立的初级保健研究的方法和结果：（i）加拿大魁北克Saguenay地区的患者（2005年）;（ii）海滩的一项子研究（2005年）;（iii）研究对象（2005年）;（iv）研究对象（2005年）;（iv）研究对象（2005年）;（iv）研究对象（2005年）。澳大利亚（改善健康评估和护理）方案（2008年）;以及（iii）加拿大安大略西南部的德尔菲（提供初级卫生保健信息）项目（2009年）。确定了多种发病率研究方法可能不同的领域。多种疾病的患病率变化高达61%，其中在Saguenay研究中报告的患病率在45 - 64岁的女性中为95%，在海滩子研究中为46%，在德尔菲研究中为34%。方法和研究设计的几个方面被确定为不同的研究，包括采样的频繁就诊者，采样周期，数据来源，以及慢性病的定义和计数，了解不同的方法之间的差异，用于生产的患病率数据在初级保健中的多发病率可以帮助解释不同的结果。方法的标准化将允许更有效的研究间比较。
As the population ages, practice and policy need to be guided by accurate estimates of chronic disease burden in primary care.To produce a preliminary set of methodological considerations for cross-sectional and retrospective cohort studies of multi-morbidity in primary care using three studies as examples. Prevalence rate results from the three studies were re-estimated using identical agesex groups.We compared the methods and results of three separate studies in primary care: (i) patients in the Saguenay region of Quebec, Canada (2005); (ii) a substudy of the BEACH (Bettering the Evaluation and Care of Health) programme in Australia (2008); and (iii) the DELPHI (Deliver Primary Health Care Information) project in South-western Ontario, Canada (2009). Areas where the methods of multi-morbidity studies may differ were identified. The percentage of patients with two or more chronic conditions was compared by agesex groups.Multi-morbidity prevalence varied by as much as 61%, where reported prevalence was 95% among females aged 4564 in the Saguenay study, 46% in the BEACH substudy and 34% in the DELPHI study. Several aspects of the methods and study designs were identified as differing among the studies, including the sampling of frequent attenders, sampling period, source of data, and both the definition and count of chronic conditions.Understanding the differences among the methods used to produce prevalence data on multi-morbidity in primary care can help explain the varying results. Standardization of methods would allow for more valid inter-study comparisons.