Household clustering of multimorbidity and associations with health and social care need

多种疾病的家庭聚集性以及与健康和社会护理需求的关联

• 批准号: MR/W000253/1
• 负责人: Clare MacRae
• 金额: $ 40.68万
• 依托单位: University of Edinburgh
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FW000253%2F1
• 关键词: Household; clustering; multimorbidity; associations; health

Background More than one in four people in the UK live with two or more long-term conditions ("multimorbidity"). Older people and people living in less affluent areas are more likely to have multiple long-term conditions. People with multiple long-term conditions often find it hard to do everything they want in their lives, are more likely to be frail and have falls, and frequently require emergency care such as hospital admissions. Clinical services and health research focuses mainly on individuals. However, where people live will also influence their health. People living in the same household or neighbourhood may have similar diets and lifestyles and may therefore also be at risk of developing long-term conditions. How people cope with illness may depend on who they live with. Living alone, or living with someone who is also ill, often affects how well a person can manage their own health. We do not properly understand how people with long-term conditions 'group' together in households and in neighbourhoods. Also, we do not understand the effect of other factors, such as who someone lives with and where they live, on their need for health and social care services. This is important because in order to address the needs of people with multiple long-term conditions, we must understand how to best organise services. Aim The aim is to investigate patterns of where people with multiple long-term conditions live by looking at individuals, households, and neighbourhoods, and in what ways this relates to how people use health and social care services (for example, emergency admission to hospital or a care home) and their likelihood of premature death. Objectives 1. To review the published research on how people with multiple long-term conditions are grouped by household and neighbourhood, and how this relates to people's use of health and social care. Using data from the population of NHS Lothian (Scotland): 2. To examine geographical patterns of multiple long-term conditions in individuals, people living in the same household, and people living in the same neighbourhood. 3. To examine whether patterns in the distribution of people with multiple long-term conditions are related to their use of health and social care and their likelihood of premature death over the study period. And using data from the population of Wales: 4. To apply objectives 2 & 3 to the population of Wales and compare with the findings from Scotland to identify if these are the same or different. This will help build understanding of how long-term conditions and place are related. Potential benefits to patients and the NHS This study will improve our understanding of where people with multiple long-term conditions live at the individual, household and neighbourhood level. It will examine how these patterns are associated with the ways in which people use health and social care, and their likelihood of premature death. Understanding this will help us design health and social care services that better support people with multiple long-term conditions. People with multiple long-term conditions are among the most vulnerable people in society and their numbers are increasing due to an ageing population, making this an issue of great importance.

在英国，超过四分之一的人患有两种或两种以上的长期疾病（“多重疾病”）。老年人和生活在较不富裕地区的人更有可能患有多种长期疾病。患有多种长期疾病的人通常很难在生活中做他们想做的一切，更容易虚弱和摔倒，并且经常需要住院等紧急护理。临床服务和健康研究主要针对个人。然而，人们居住的地方也会影响他们的健康。生活在同一家庭或社区的人们可能有相似的饮食和生活方式，因此也可能面临发展长期疾病的风险。人们如何应对疾病可能取决于他们和谁住在一起。独自生活，或与生病的人住在一起，往往会影响一个人管理自己健康的能力。我们不能正确理解患有长期疾病的人是如何在家庭和社区中“聚集”在一起的。此外，我们也不了解其他因素，如与谁同住以及住在哪里，对他们对保健和社会保健服务需求的影响。这一点很重要，因为为了满足患有多种长期疾病的人的需求，我们必须了解如何最好地组织服务。目的是通过观察个人、家庭和社区，调查患有多种长期疾病的人的生活模式，以及这与人们如何使用卫生和社会护理服务（例如，紧急入院医院或养老院）及其过早死亡的可能性之间的关系。目标1。审查已发表的关于如何按家庭和社区对患有多种长期疾病的人进行分组以及这与人们使用卫生和社会保健的关系的研究。使用来自NHS洛锡安（苏格兰）人口的数据：研究个人、同一家庭和同一社区多重长期状况的地理模式。3. 研究患有多种长期疾病的人的分布模式是否与他们在研究期间使用健康和社会护理以及过早死亡的可能性有关。使用威尔士人口的数据：4。将目标2和3应用于威尔士人口，并与苏格兰的调查结果进行比较，以确定它们是否相同或不同。这将有助于建立对长期条件和地点之间关系的理解。这项研究将提高我们对患有多种长期疾病的人在个人、家庭和社区层面上生活的理解。它将研究这些模式如何与人们使用卫生和社会保健的方式以及他们过早死亡的可能性相关联。了解这一点将有助于我们设计健康和社会护理服务，更好地支持患有多种长期疾病的人。患有多种长期疾病的人是社会中最脆弱的人群之一，由于人口老龄化，他们的人数正在增加，因此这是一个非常重要的问题。

项目成果

Multimorbidity and comorbidity patterns in the English National Health Service.

• DOI: 10.1016/j.xcrm.2022.100863
• 发表时间: 2022-12-20
• 期刊: CELL REPORTS MEDICINE
• 影响因子: 14.3
• 作者: MacRae, Clare;Henderson, David;Guthrie, Bruce;Mercer, Stewart W.
• 通讯作者: Mercer, Stewart W.

Household and area determinants of emergency department attendance and hospitalisation in people with multimorbidity: a systematic review.

• DOI: 10.1136/bmjopen-2022-063441
• 发表时间: 2022-10-03
• 期刊: BMJ open
• 影响因子: 2.9

Impact of data source choice on multimorbidity measurement: a comparison study of 2.3 million individuals in the Welsh National Health Service.

• DOI: 10.1186/s12916-023-02970-z
• 发表时间: 2023-08-15
• 期刊: BMC MEDICINE
• 影响因子: 9.3
• 作者: MacRae, Clare;Morales, Daniel;Mercer, Stewart W.;Lone, Nazir;Lawson, Andrew;Jefferson, Emily;McAllister, David;van den Akker, Marjan;Marshall, Alan;Seth, Sohan;Rawlings, Anna;Lyons, Jane;Lyons, Ronan A.;Mizen, Amy;Abubakar, Eleojo;Dibben, Chris;Guthrie, Bruce
• 通讯作者: Guthrie, Bruce

Epidemiology of health and social care outcomes stratified by multimorbidity status in Wales examining household and area covariates: study protocol for a multilevel analysis

威尔士按多发病状况分层的健康和社会护理结果的流行病学检查家庭和地区协变量：多层次分析的研究方案

• 发表时间: 2023
• 期刊: PLOS ONE
• 影响因子: 3.7
• 作者: MacRae Clare

The impact of varying the number and selection of conditions on estimated multimorbidity prevalence: A cross-sectional study using a large, primary care population dataset.

改变条件数量和选择对估计多发病率的影响的影响：使用大型初级保健人群数据集的横断面研究。

• DOI: 10.1371/journal.pmed.1004208
• 发表时间: 2023-04
• 期刊: PLoS medicine
• 影响因子: 15.8