Mini G K, Thankappan K R
Centre for Public Health, Amrita Institute of Medical Sciences (AIMS), Amrita Vishwa Vidyapeetham University, School of Medicine, Health Science Campus, Kochi, Kerala, India.
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
BMJ Open. 2017 Mar 8;7(3):e013529. doi: 10.1136/bmjopen-2016-013529.
The objective of the present study was to estimate the proportion of older adults with non-communicable disease (NCD) multimorbidity, its correlates and implications in selected Indian states.
The study used data of 9852 older adults (≥60 years) (men 47%, mean age 68 years) collected by the United Nations Population Fund from seven selected Indian states. Multiple logistic regression analysis was used to assess the correlates of NCD multimorbidity and hospitalisation.
NCD multimorbidity was reported by 30.7% (95% CI 29.8 to 31.7). Those in the highest wealth group, aged ≥70 years, alcohol users, women and tobacco users were more likely to report NCD multimorbidity compared to those without any NCD and single NCD. Those with multimorbidity, the wealthiest, ever tobacco users and those who had formal education were more likely to be hospitalised compared to their counterparts after adjusting for age, sex and ever use of alcohol.
Multimorbidity needs to be considered for planning NCD healthcare services provision particularly inpatient facilities focusing on alcohol users, tobacco users and women. Further studies are required to find out reasons for higher rates of multimorbidity among the wealthier group other than higher healthcare services usage and detection rates.
本研究的目的是估计印度部分邦患有非传染性疾病(NCD)多重疾病的老年人比例、其相关因素及影响。
该研究使用了联合国人口基金从印度七个选定邦收集的9852名老年人(≥60岁)(男性占47%,平均年龄68岁)的数据。采用多元逻辑回归分析来评估非传染性疾病多重疾病和住院治疗的相关因素。
30.7%(95%置信区间29.8至31.7)的老年人报告患有非传染性疾病多重疾病。与没有任何非传染性疾病和单一非传染性疾病的人相比,最富有财富组、年龄≥70岁、饮酒者、女性和吸烟者更有可能报告患有非传染性疾病多重疾病。在调整年龄、性别和饮酒史后,患有多重疾病的人、最富有的人、曾经吸烟的人和受过正规教育的人比他们的对应人群更有可能住院。
在规划非传染性疾病医疗服务提供时,特别是针对住院设施,需要考虑多重疾病问题,重点关注饮酒者、吸烟者和女性。需要进一步研究以找出除了更高的医疗服务使用率和检出率之外,较富有群体中多重疾病发生率更高的原因。