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Prevalence of multimorbidity according to the deprivation level among the elderly in the Basque Country.

Orueta JF, Nuño-Solinís R, García-Alvarez A, Alonso-Morán E - BMC Public Health (2013)

Bottom Line: Multimorbidity was found in 66.13% of the population aged 65 and over and increases with age until 80 years.The prevalence of multimorbidity was higher in deprived (69.94%) than better-off (60.22%) areas.Administrative health databases are readily available sources of a range of information that can be useful for such purposes.

View Article: PubMed Central - HTML - PubMed

Affiliation: O+berri, Basque Institute for Healthcare Innovation, Plaza Asua 1, 48150 Sondika, Spain. jon.orueta@osakidetza.net.

ABSTRACT

Background: Multimorbidity is clearly a major challenge for healthcare systems. However, currently, its magnitude and impact on healthcare expenditures is still not well known. The objective of this paper is to present an overview of the prevalence of multimorbidity by deprivation level in the elderly population of the Basque Country.

Methods: We conducted a cross-sectional analysis that included all the inhabitants of the Basque Country aged 65 years and over (N = 452,698). This was based on data from primary care electronic medical records, hospital admissions, and outpatient care databases, for a 4-year period. The health problems of the patients were identified from their diagnoses and prescriptions. Multimorbidity was defined as the presence of two or more chronic diseases out of a list of 47 of the most important and common chronic conditions consistent with the literature. In addition, we explored socio-economic and demographic variables such as age, sex, and deprivation level.

Results: Multimorbidity was found in 66.13% of the population aged 65 and over and increases with age until 80 years. The prevalence of multimorbidity was higher in deprived (69.94%) than better-off (60.22%) areas. This pattern of differences between the most and least disadvantaged areas was observed in all age groups and more marked in female (70.96-59.78%) than in male (68.54-60.86%) populations. In almost all diseases studied (43 out of 47), 90% of patients had been diagnosed with at least one other illness. It was also frequent the coexistence of mental and physical health problems in the same person and the presence of multiple physical diseases is higher in patients with mental disease than in the rest of population (74.97% vs. 58.14%).

Conclusion: Multimorbidity is very common among people over 65 years old in the Basque Country, particularly in unfavourable socioeconomic environments. Given the ageing population, multimorbidity and its consequences should be taken into account in healthcare policy, organization of care and medical research. Administrative health databases are readily available sources of a range of information that can be useful for such purposes.

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Percentage of women with multimorbidity (at least 2 and at least 3 chronic conditions) by deprivation index.
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Figure 1: Percentage of women with multimorbidity (at least 2 and at least 3 chronic conditions) by deprivation index.

Mentions: More than half of over 65-year-olds and more than 75% of the population between 80 and 84 years old were classified as having multimorbidity, because they had at least two chronic health problems (Table 2), and the differences between sexes are not significant (p = 0.521). The coexistence of even more chronic conditions in the same person is also common, three or more pathologies being found in 30% of the population at 65 and 60% at 85 years of age. Again, the pattern of differences between the groups with the most and least favourable socio-economic status varied between the sexes. While women showed larger disparities and there was a strong gradient between these groups (Figure 1), in men discrepancies were less apparent: the lowest prevalences of multimorbidity were observed in the least disadvantaged, but there were relatively small differences between the other groups (Figure 2).


Prevalence of multimorbidity according to the deprivation level among the elderly in the Basque Country.

Orueta JF, Nuño-Solinís R, García-Alvarez A, Alonso-Morán E - BMC Public Health (2013)

Percentage of women with multimorbidity (at least 2 and at least 3 chronic conditions) by deprivation index.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3852493&req=5

Figure 1: Percentage of women with multimorbidity (at least 2 and at least 3 chronic conditions) by deprivation index.
Mentions: More than half of over 65-year-olds and more than 75% of the population between 80 and 84 years old were classified as having multimorbidity, because they had at least two chronic health problems (Table 2), and the differences between sexes are not significant (p = 0.521). The coexistence of even more chronic conditions in the same person is also common, three or more pathologies being found in 30% of the population at 65 and 60% at 85 years of age. Again, the pattern of differences between the groups with the most and least favourable socio-economic status varied between the sexes. While women showed larger disparities and there was a strong gradient between these groups (Figure 1), in men discrepancies were less apparent: the lowest prevalences of multimorbidity were observed in the least disadvantaged, but there were relatively small differences between the other groups (Figure 2).

Bottom Line: Multimorbidity was found in 66.13% of the population aged 65 and over and increases with age until 80 years.The prevalence of multimorbidity was higher in deprived (69.94%) than better-off (60.22%) areas.Administrative health databases are readily available sources of a range of information that can be useful for such purposes.

View Article: PubMed Central - HTML - PubMed

Affiliation: O+berri, Basque Institute for Healthcare Innovation, Plaza Asua 1, 48150 Sondika, Spain. jon.orueta@osakidetza.net.

ABSTRACT

Background: Multimorbidity is clearly a major challenge for healthcare systems. However, currently, its magnitude and impact on healthcare expenditures is still not well known. The objective of this paper is to present an overview of the prevalence of multimorbidity by deprivation level in the elderly population of the Basque Country.

Methods: We conducted a cross-sectional analysis that included all the inhabitants of the Basque Country aged 65 years and over (N = 452,698). This was based on data from primary care electronic medical records, hospital admissions, and outpatient care databases, for a 4-year period. The health problems of the patients were identified from their diagnoses and prescriptions. Multimorbidity was defined as the presence of two or more chronic diseases out of a list of 47 of the most important and common chronic conditions consistent with the literature. In addition, we explored socio-economic and demographic variables such as age, sex, and deprivation level.

Results: Multimorbidity was found in 66.13% of the population aged 65 and over and increases with age until 80 years. The prevalence of multimorbidity was higher in deprived (69.94%) than better-off (60.22%) areas. This pattern of differences between the most and least disadvantaged areas was observed in all age groups and more marked in female (70.96-59.78%) than in male (68.54-60.86%) populations. In almost all diseases studied (43 out of 47), 90% of patients had been diagnosed with at least one other illness. It was also frequent the coexistence of mental and physical health problems in the same person and the presence of multiple physical diseases is higher in patients with mental disease than in the rest of population (74.97% vs. 58.14%).

Conclusion: Multimorbidity is very common among people over 65 years old in the Basque Country, particularly in unfavourable socioeconomic environments. Given the ageing population, multimorbidity and its consequences should be taken into account in healthcare policy, organization of care and medical research. Administrative health databases are readily available sources of a range of information that can be useful for such purposes.

Show MeSH
Related in: MedlinePlus