Hopman Petra, Schellevis François G, Rijken Mieke
Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.
Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
Qual Life Res. 2016 Mar;25(3):651-60. doi: 10.1007/s11136-015-1102-8. Epub 2015 Sep 4.
To examine the health-related needs of people with multiple chronic diseases in the Netherlands compared to people with one chronic disease, and to identify different subgroups of multimorbid patients based on differences in their health problems.
Participants were 1092 people with one or more chronic diseases of a nationwide prospective panel study on the consequences of chronic illness in the Netherlands. They completed the EQ-6D, a multi-dimensional questionnaire on health problems (October 2013). Chi-square tests and analyses of variance were performed to test for differences between multimorbid patients and patients with one chronic disease. To identify subgroups of multimorbid patients, cluster analysis was performed and differences in EQ-6D scores between clusters were tested with Chi-square tests.
Multimorbid patients (51 % of the total sample) experience more problems in most health domains than patients with one chronic disease. Almost half (44 %) of the multimorbid people had many health problems in different domains. These people were more often female, had a smaller household size, had a lower health literacy, and suffered from more chronic diseases. Remarkably, a small subgroup of multimorbid patients (4 %, mostly elderly males) is characterized by all having cognitive problems.
Based on the problems they experience, we conclude that patients with multimorbidity have relatively many and diverse health-related needs. Extensive health-related needs among people with multimorbidity may relate not only to the number of chronic diseases they suffer from, but also to their patient characteristics. This should be taken into account, when identifying target groups for comprehensive support programmes.
与患有一种慢性病的人群相比，研究荷兰患有多种慢性病的人群的健康相关需求，并根据其健康问题的差异确定多病患者的不同亚组。
参与者为荷兰一项关于慢性病后果的全国性前瞻性小组研究中的1092名患有一种或多种慢性病的人。他们完成了EQ-6D，这是一份关于健康问题的多维问卷（2013年10月）。进行卡方检验和方差分析以检验多病患者与患有一种慢性病的患者之间的差异。为了确定多病患者的亚组，进行了聚类分析，并用卡方检验测试了各聚类之间EQ-6D得分的差异。
多病患者（占总样本的51%）在大多数健康领域比患有一种慢性病的患者有更多问题。几乎一半（44%）的多病患者在不同领域有许多健康问题。这些人女性居多，家庭规模较小，健康素养较低，患有更多慢性病。值得注意的是，一小部分多病患者亚组（4%，大多为老年男性）的特征是都有认知问题。
根据他们所经历的问题，我们得出结论，多病患者有相对较多且多样的健康相关需求。多病患者广泛的健康相关需求可能不仅与其患有的慢性病数量有关，还与其患者特征有关。在确定综合支持计划的目标群体时应考虑到这一点。
