Lenzi Jacopo, Avaldi Vera Maria, Rucci Paola, Pieri Giulia, Fantini Maria Pia
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
BMJ Open. 2016 Dec 21;6(12):e012812. doi: 10.1136/bmjopen-2016-012812.
Many studies have investigated multimorbidity, whose prevalence varies according to settings and data sources. However, few studies on this topic have been conducted in Italy, a country with universal healthcare and one of the most aged populations in the world. The aim of this study was to estimate the prevalence of multimorbidity in a Northern Italian region, to investigate its distribution by age, gender and citizenship and to analyse the correlations of diseases.
Cross-sectional study based on administrative data.
Emilia-Romagna, an Italian region with ∼4.4 million inhabitants, of which almost one-fourth are aged ≥65 years.
All adults residing in Emilia-Romagna on 31 December 2012. Hospitalisations, drug prescriptions and contacts with community mental health services from 2003 to 2012 were traced to identify the presence of 17 physical and 9 mental health disorders.
Descriptive analysis of differences in the prevalence of multimorbidity in relation to age, gender and citizenship. The correlations of diseases were analysed using exploratory factor analysis.
The study population included 622 026 men and 751 011women, with a mean age of 66.4 years. Patients with multimorbidity were 33.5% in 75 years and >60% among patients aged ≥90 years; among patients aged ≥65 years, the proportion of multimorbidity was 39.9%. After standardisation by age and gender, multimorbidity was significantly more frequent among Italian citizens than among immigrants. Factor analysis identified 5 multimorbidity patterns: (1) psychiatric disorders, (2) cardiovascular, renal, pulmonary and cerebrovascular diseases, (3) neurological diseases, (4) liver diseases, AIDS/HIV and substance abuse and (5) tumours.
Multimorbidity was highly prevalent in Emilia-Romagna and strongly associated with age. This finding highlights the need for healthcare providers to adopt individualised care plans and ensure continuity of care.
许多研究对多种疾病并存情况进行了调查，其患病率因研究背景和数据来源而异。然而，在意大利这个拥有全民医疗保健且是世界上老年人口最多的国家之一，针对该主题的研究却很少。本研究的目的是估计意大利北部一个地区多种疾病并存的患病率，调查其在年龄、性别和国籍方面的分布情况，并分析疾病之间的相关性。
基于行政数据的横断面研究。
艾米利亚 - 罗马涅，意大利的一个地区，有大约440万居民，其中近四分之一年龄在65岁及以上。
2012年12月31日居住在艾米利亚 - 罗马涅的所有成年人。追溯2003年至2012年的住院情况、药物处方以及与社区心理健康服务机构的接触记录，以确定17种身体疾病和9种精神疾病的患病情况。
对多种疾病并存患病率在年龄、性别和国籍方面的差异进行描述性分析。使用探索性因素分析来分析疾病之间的相关性。
研究人群包括622026名男性和751011名女性，平均年龄为66.4岁。75岁人群中多种疾病并存的患者比例为33.5%，90岁及以上患者中这一比例超过60%；在65岁及以上患者中，多种疾病并存的比例为39.9%。经年龄和性别标准化后，意大利公民中多种疾病并存的情况明显比移民更为常见。因素分析确定了5种多种疾病并存模式：（1）精神疾病，（2）心血管、肾脏、肺部和脑血管疾病，（3）神经系统疾病，（4）肝脏疾病、艾滋病/艾滋病毒感染和药物滥用，（5）肿瘤。
多种疾病并存在艾米利亚 - 罗马涅地区非常普遍，且与年龄密切相关。这一发现凸显了医疗服务提供者采用个性化护理计划并确保护理连续性的必要性。
