Urban-rural and socioeconomic status: Impact on multimorbidity prevalence in hospitalized patients.
Urban-rural and socioeconomic status: Impact on multimorbidity prevalence in hospitalized patients.
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DOI：
10.1177/2235042x19893470
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发表时间：
2020-01-01
影响因子：
--
通讯作者：
Black, Corri
中科院分区：
文献类型：
--
作者：
Robertson, Lynn;Ayansina, Dolapo;Black, Corri
目的：通过城乡居住地和社会经济地位(SES)描述成人住院期间的多病患病率。2014年在苏格兰格兰宾住院的成年人(≥18岁)包括在内。从2014年首次入院前5年的入院情况中确定了条件。多发病定义为≥-2状态，采用Tonelli等人的方法进行测量。根据国际疾病分类--10编码(预选的30种疾病清单)。我们使用比例和95%可信区间(CI)来总结按年龄组、性别、城乡类别和贫困程度划分的多发病患病率。结果：共纳入41,545例患者(中位年龄62岁，女性52.6%)。总体而言，27.4%(95%可信区间27.0，27.8)的患者是多病。大城市多发病患病率为28.8%(95%可信区间28.1，29.5)，边远农村为22.0%(95%可信区间20.9，23.3)，最贫困地区为28.7%(95%可信区间27.2，30.3)，最贫困地区为26.0%(95%可信区间25.2，26.9)。这种影响在所有年龄组中都是一致的，但在18-29岁的年龄组中没有统计学意义。男性和女性的多发病随年龄增长而增加，但男性和女性的多病患病率相似。结论：鉴于城乡地区和自闭症患者对多发病患病率的影响的研究尚不多见，这些发现将为未来研究新的护理模式提供参考，包括考虑城乡地区和自闭症患者的自闭症。
OBJECTIVE: The aim of this study was to describe multimorbidity prevalence in hospitalized adults, by urban-rural area of residence and socioeconomic status (SES).METHODS: Linked hospital episode data were used. Adults (≥18 years) admitted to hospital as an inpatient during 2014 in Grampian, Scotland, were included. Conditions were identified from admissions during the 5 years prior to the first admission in 2014. Multimorbidity was defined as ≥2 conditions and measured using Tonelli et al. based on International Classification of Diseases-10 coding (preselected list of 30 conditions). We used proportions and 95% confidence intervals (CIs) to summarize the prevalence of multimorbidity by age group, sex, urban-rural category and deprivation. The association between multimorbidity and patient characteristics was assessed using the chi 2 test.RESULTS: Forty one thousand five hundred and forty-five patients were included (median age 62, 52.6% female). Overall, 27.4% (95% CI 27.0, 27.8) of patients were multimorbid. Multimorbidity prevalence was 28.8% (95% CI 28.1, 29.5) in large urban versus 22.0% (95% CI 20.9, 23.3) in remote rural areas and 28.7% (95% CI 27.2, 30.3) in the most deprived versus 26.0% (95% CI 25.2, 26.9) in the least deprived areas. This effect was consistent in all age groups, but not statistically significant in the age group 18-29 years. Multimorbidity increased with age but was similar for males and females.CONCLUSION: Given the scarcity of research into the effect of urban-rural area and SES on multimorbidity prevalence among hospitalized patients, these findings should inform future research into new models of care, including the consideration of urban-rural area and SES.