Lowe Dianne B, Taylor Michael J, Hill Sophie J
Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.
Cochrane Consumers and Communication Review Group, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.
BMC Res Notes. 2017 Jan 18;10(1):51. doi: 10.1186/s13104-017-2376-4.
Multimorbidity and musculoskeletal conditions create substantial burden for people and health systems. Quantifying the extent of co-occurring conditions is hampered by conceptual heterogeneity, imprecision and/or indecision about how multimorbidity is defined. The purpose of this study is to examine the influence of different ways of operationalising multimorbidity on multimorbidity prevalence rates with a focus on working-age adults with musculoskeletal conditions. Weighted population prevalence rates of multimorbidity among working-age Australians were estimated using data from the National Health Survey. Two nominal thresholds (2+ or 3+ co-occurring conditions) and three operational definitions of multimorbidity (survey-, policy- and research-based) were examined. Using logistic regression, we estimated the association between the prevalence of multimorbidity among persons with musculoskeletal conditions compared to persons with non-musculoskeletal conditions for each definition and threshold combination.
As few as 7.9% of working-age Australians have 2+ conditions using the research-based definition (95% CI 7.4-8.5%), compared to estimates of 15.3% (95% CI 14.3-16.2%) and 61.5% (95% CI 60.3-62.7%). with the policy- and survey-based definitions, respectively. Depending on definition, with the 3+ threshold multimorbidity prevalence ranged from 2.1% (research) to 41.9% (survey). Among the sub-sample with musculoskeletal conditions, multimorbidity with the 2+ threshold ranged from 20.2 to 92.2%; and with 3+ threshold from 5.9 to 75.4%, again lowest with the research-definition and highest with the survey-definition. When compared to any other condition (i.e. non-musculoskeletal conditions), all musculoskeletal conditions were positively associated with multimorbidity, regardless of definition or threshold.
Depending on definition and threshold, multimorbidity is either rare or endemic in working-age Australians. Irrespective of definition, musculoskeletal conditions are a near-ubiquitous feature of multimorbidity.
多种疾病并存和肌肉骨骼疾病给个人和卫生系统带来了沉重负担。由于概念上的异质性、对多种疾病并存定义的不精确性和/或不确定性，量化共病情况的程度受到阻碍。本研究的目的是探讨多种疾病并存的不同操作方式对多种疾病并存患病率的影响，重点关注患有肌肉骨骼疾病的工作年龄成年人。利用国家健康调查的数据估计了澳大利亚工作年龄人群中多种疾病并存的加权患病率。研究了两个名义阈值（2种及以上或3种及以上共病情况）和三种多种疾病并存的操作定义（基于调查、基于政策和基于研究）。使用逻辑回归，我们估计了每种定义和阈值组合下，患有肌肉骨骼疾病的人与未患有肌肉骨骼疾病的人相比，多种疾病并存患病率之间的关联。
使用基于研究的定义，只有7.9%的澳大利亚工作年龄人群患有2种及以上疾病（95%置信区间7.4 - 8.5%），而基于政策和基于调查的定义的估计值分别为15.3%（95%置信区间14.3 - 16.2%）和61.5%（95%置信区间60.3 - 62.7%）。根据定义，对于3种及以上阈值，多种疾病并存患病率从2.1%（基于研究）到41.9%（基于调查）不等。在患有肌肉骨骼疾病的子样本中，2种及以上阈值的多种疾病并存率从20.2%到92.2%不等；3种及以上阈值的从5.9%到75.4%不等，同样基于研究的定义最低，基于调查的定义最高。与任何其他疾病（即非肌肉骨骼疾病）相比，所有肌肉骨骼疾病都与多种疾病并存呈正相关，无论定义或阈值如何。
根据定义和阈值，多种疾病并存在澳大利亚工作年龄人群中要么罕见要么普遍存在。无论定义如何，肌肉骨骼疾病都是多种疾病并存的一个几乎普遍的特征。
