Multiprofessional Education Unit for Family and Community Care (Southwest), Madrid, Spain.
PLoS One. 2012;7(2):e32141. doi: 10.1371/journal.pone.0032141. Epub 2012 Feb 16.
Healthcare management is oriented toward single diseases, yet multimorbidity is nevertheless the rule and there is a tendency for certain diseases to occur in clusters. This study sought to identify comorbidity patterns in patients with chronic diseases, by reference to number of comorbidities, age and sex, in a population receiving medical care from 129 general practitioners in Spain, in 2007.
A cross-sectional study was conducted in a health-area setting of the Madrid Autonomous Region (Comunidad Autónoma), covering a population of 198,670 individuals aged over 14 years. Multiple correspondences were analyzed to identify the clustering patterns of the conditions targeted.
Forty-two percent (95% confidence interval [CI]: 41.8-42.2) of the registered population had at least one chronic condition. In all, 24.5% (95% CI: 24.3-24.6) of the population presented with multimorbidity. In the correspondence analysis, 98.3% of the total information was accounted for by three dimensions. The following four, age- and sex-related comorbidity patterns were identified: pattern B, showing a high comorbidity rate; pattern C, showing a low comorbidity rate; and two patterns, A and D, showing intermediate comorbidity rates.
Four comorbidity patterns could be identified which grouped diseases as follows: one showing diseases with a high comorbidity burden; one showing diseases with a low comorbidity burden; and two showing diseases with an intermediate comorbidity burden.
医疗保健管理以单一疾病为导向,但合并症仍是常态,某些疾病倾向于成组出现。本研究旨在通过参考西班牙 129 名全科医生医疗服务人群中的合并症数量、年龄和性别,确定患有慢性病患者的合并症模式。
在马德里自治区(自治区)的卫生区域环境中进行了一项横断面研究,涵盖了 198670 名 14 岁以上的个体。通过多重对应分析来确定目标条件的聚类模式。
42%(95%置信区间[CI]:41.8-42.2)的登记人口至少有一种慢性病。在所有人群中,24.5%(95%CI:24.3-24.6)的人患有多种合并症。在对应分析中,总信息量的 98.3%由三个维度解释。确定了以下四个与年龄和性别相关的合并症模式:模式 B,具有高合并症发生率;模式 C,具有低合并症发生率;和两个模式 A 和 D,具有中等合并症发生率。
可以识别出四种合并症模式,将疾病分为以下几类:一种具有高合并症负担的疾病;一种具有低合并症负担的疾病;以及两种具有中等合并症负担的疾病。