Islam M Mofizul, McRae Ian S, Yen Laurann, Jowsey Tanisha, Valderas Jose M
Australian Primary Health Care Research Institute, Australian National University, Australian Capital Territory.
Health Services and Policy Research, University of Exeter Medical School, England, UK.
Aust N Z J Public Health. 2015 Jun;39(3):277-83. doi: 10.1111/1753-6405.12355. Epub 2015 Apr 22.
To examine the effect of various morbidity clusters of chronic diseases on health-related time use and to explore factors associated with heavy time burden (more than 30 hours/month) of health-related activities.
Using a national survey, data were collected from 2,540 senior Australians. Natural clusters were identified using cluster analysis and clinical clusters using clinical expert opinion. We undertook a set of linear regressions to model people's time use, and logistic regressions to model heavy time burden.
Time use increases with the number of chronic diseases. Six of the 12 diseases are significantly associated with higher time use, with the highest effect for diabetes followed by depression; 18% reported a heavy time burden, with diabetes again being the most significant disease. Clusters and dominant comorbid groupings do not contribute to predicting time use or time burden.
Total number of diseases and specific diseases are useful determinants of time use and heavy time burden. Dominant groupings and disease clusters do not predict time use.
In considering time demands on patients and the need for care co-ordination, care providers need to be aware of how many and what specific diseases the patient faces.
研究各类慢性病发病集群对与健康相关的时间利用的影响，并探索与健康相关活动的沉重时间负担（每月超过30小时）相关的因素。
利用一项全国性调查，收集了2540名澳大利亚老年人的数据。使用聚类分析确定自然集群，使用临床专家意见确定临床集群。我们进行了一组线性回归以模拟人们的时间利用情况，并进行逻辑回归以模拟沉重的时间负担。
时间利用随着慢性病数量的增加而增加。12种疾病中有6种与更高的时间利用显著相关，其中糖尿病影响最大，其次是抑郁症；18%的人报告有沉重的时间负担，糖尿病再次成为最显著的疾病。集群和主要共病分组对预测时间利用或时间负担没有帮助。
疾病总数和特定疾病是时间利用和沉重时间负担的有用决定因素。主要分组和疾病集群无法预测时间利用情况。
在考虑患者的时间需求和护理协调的必要性时，护理提供者需要了解患者面临多少种以及具体是哪些特定疾病。
