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Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: A Cluster Analysis.

Foguet-Boreu Q, Violán C, Rodriguez-Blanco T, Roso-Llorach A, Pons-Vigués M, Pujol-Ribera E, Cossio Gil Y, Valderas JM - PLoS ONE (2015)

Bottom Line: The greatest overlap (54.5%) between the three most common diagnoses was observed in women aged 65-79 years.Clusters unknown to date have been identified.The clusters identified should be considered when developing clinical guidance for this population.

View Article: PubMed Central - PubMed

Affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain; University of Girona, Carrer Emili Grahit, 77, Girona, Catalonia, Spain.

ABSTRACT

Objective: The purpose of this study was to identify clusters of diagnoses in elderly patients with multimorbidity, attended in primary care.

Design: Cross-sectional study.

Setting: 251 primary care centres in Catalonia, Spain.

Participants: Individuals older than 64 years registered with participating practices.

Main outcome measures: Multimorbidity, defined as the coexistence of 2 or more ICD-10 disease categories in the electronic health record. Using hierarchical cluster analysis, multimorbidity clusters were identified by sex and age group (65-79 and ≥80 years).

Results: 322,328 patients with multimorbidity were included in the analysis (mean age, 75.4 years [Standard deviation, SD: 7.4], 57.4% women; mean of 7.9 diagnoses [SD: 3.9]). For both men and women, the first cluster in both age groups included the same two diagnoses: Hypertensive diseases and Metabolic disorders. The second cluster contained three diagnoses of the musculoskeletal system in the 65- to 79-year-old group, and five diseases coincided in the ≥80 age group: varicose veins of the lower limbs, senile cataract, dorsalgia, functional intestinal disorders and shoulder lesions. The greatest overlap (54.5%) between the three most common diagnoses was observed in women aged 65-79 years.

Conclusion: This cluster analysis of elderly primary care patients with multimorbidity, revealed a single cluster of circulatory-metabolic diseases that were the most prevalent in both age groups and sex, and a cluster of second-most prevalent diagnoses that included musculoskeletal diseases. Clusters unknown to date have been identified. The clusters identified should be considered when developing clinical guidance for this population.

No MeSH data available.


Related in: MedlinePlus

Sampling framework.Abbreviations: PHCT, primary health care teams; SIDIAP-Q, Information System for the Development of Research in Primary Care- Quality
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pone.0141155.g001: Sampling framework.Abbreviations: PHCT, primary health care teams; SIDIAP-Q, Information System for the Development of Research in Primary Care- Quality

Mentions: A cross-sectional study was conducted in Catalonia (Spain), a Mediterranean region with 7,434,632 inhabitants, 81% of which live in urban municipalities (2010 census). The Spanish National Health Service (NHS) provides universal coverage, financed mainly by tax revenue. The Catalan Health Institute (CHI) manages primary health care teams (PHCTs) that serve 5,501,784 patients (274 PHCT), or 74% of the population; the remaining PHCTs are managed by other providers. The CHI’s Information System for the Development of Research in Primary Care (SIDIAP) contains the coded clinical information recorded in EHR by its 274 PHCTs since 2006. A subset of records meeting the highest quality criteria for clinical data (SIDIAP Q) includes 40% of the SIDIAP population (1,833,125 individuals), attended by the 1,365 general practitioners (GPs) whose data recording scored highest in a validated comparison process [11]. We selected individuals older than 64 years on 31 December 2010 with two or more diagnoses (Fig 1).


Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: A Cluster Analysis.

Foguet-Boreu Q, Violán C, Rodriguez-Blanco T, Roso-Llorach A, Pons-Vigués M, Pujol-Ribera E, Cossio Gil Y, Valderas JM - PLoS ONE (2015)

Sampling framework.Abbreviations: PHCT, primary health care teams; SIDIAP-Q, Information System for the Development of Research in Primary Care- Quality
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4629893&req=5

pone.0141155.g001: Sampling framework.Abbreviations: PHCT, primary health care teams; SIDIAP-Q, Information System for the Development of Research in Primary Care- Quality
Mentions: A cross-sectional study was conducted in Catalonia (Spain), a Mediterranean region with 7,434,632 inhabitants, 81% of which live in urban municipalities (2010 census). The Spanish National Health Service (NHS) provides universal coverage, financed mainly by tax revenue. The Catalan Health Institute (CHI) manages primary health care teams (PHCTs) that serve 5,501,784 patients (274 PHCT), or 74% of the population; the remaining PHCTs are managed by other providers. The CHI’s Information System for the Development of Research in Primary Care (SIDIAP) contains the coded clinical information recorded in EHR by its 274 PHCTs since 2006. A subset of records meeting the highest quality criteria for clinical data (SIDIAP Q) includes 40% of the SIDIAP population (1,833,125 individuals), attended by the 1,365 general practitioners (GPs) whose data recording scored highest in a validated comparison process [11]. We selected individuals older than 64 years on 31 December 2010 with two or more diagnoses (Fig 1).

Bottom Line: The greatest overlap (54.5%) between the three most common diagnoses was observed in women aged 65-79 years.Clusters unknown to date have been identified.The clusters identified should be considered when developing clinical guidance for this population.

View Article: PubMed Central - PubMed

Affiliation: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). Universitat Autònoma de Barcelona, Gran Via Corts Catalanes, 587 àtic, Barcelona, Spain; University of Girona, Carrer Emili Grahit, 77, Girona, Catalonia, Spain.

ABSTRACT

Objective: The purpose of this study was to identify clusters of diagnoses in elderly patients with multimorbidity, attended in primary care.

Design: Cross-sectional study.

Setting: 251 primary care centres in Catalonia, Spain.

Participants: Individuals older than 64 years registered with participating practices.

Main outcome measures: Multimorbidity, defined as the coexistence of 2 or more ICD-10 disease categories in the electronic health record. Using hierarchical cluster analysis, multimorbidity clusters were identified by sex and age group (65-79 and ≥80 years).

Results: 322,328 patients with multimorbidity were included in the analysis (mean age, 75.4 years [Standard deviation, SD: 7.4], 57.4% women; mean of 7.9 diagnoses [SD: 3.9]). For both men and women, the first cluster in both age groups included the same two diagnoses: Hypertensive diseases and Metabolic disorders. The second cluster contained three diagnoses of the musculoskeletal system in the 65- to 79-year-old group, and five diseases coincided in the ≥80 age group: varicose veins of the lower limbs, senile cataract, dorsalgia, functional intestinal disorders and shoulder lesions. The greatest overlap (54.5%) between the three most common diagnoses was observed in women aged 65-79 years.

Conclusion: This cluster analysis of elderly primary care patients with multimorbidity, revealed a single cluster of circulatory-metabolic diseases that were the most prevalent in both age groups and sex, and a cluster of second-most prevalent diagnoses that included musculoskeletal diseases. Clusters unknown to date have been identified. The clusters identified should be considered when developing clinical guidance for this population.

No MeSH data available.


Related in: MedlinePlus