Gimeno-Feliu Luis Andrés, Calderón-Larrañaga Amaia, Díaz Esperanza, Laguna-Berna Clara, Poblador-Plou Beatriz, Coscollar Carlos, Prados-Torres Alexandra
San Pablo Health Centre, Aragón Health Service, Zaragoza, Spain.
EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain.
Fam Pract. 2017 Nov 16;34(6):662-666. doi: 10.1093/fampra/cmx048.
Multimorbidity is a growing phenomenon in primary care, and knowledge of the influence of social determinants on its evolution is vital. The aim of this study was to understand the relationship between multimorbidity and immigration, taking into account length of residence in the host country and area of origin of the immigrant population.
Cross-sectional retrospective study of all adult patients registered within the public health service of Aragon, Spain (N = 1092279; 144238 were foreign-born), based on data from the EpiChron Cohort. Age-standardized prevalence rates of multimorbidity were calculated. Different models of binary logistic regressions were conducted to study the association between multimorbidity, immigrant status and length of residence in the host country.
The risk of multimorbidity in foreign-borns was lower than that of native-borns [odds ratio (OR): 0.54, 95% confidence interval (CI): 0.53-0.55]. The probability of experiencing multimorbidity was lowest for Asians (OR: 0.34, 95% CI: 0.31-0.37) and Eastern Europeans (OR: 0.42, 95% CI: 0.40-0.43), and highest for Latin Americans (OR: 0.70, 95% CI: 0.68-0.72). Foreign-born immigrants residing in Aragon for ≥5 years had a higher multimorbidity risk than those residing for <5 years (OR: 2.3, 95% CI: 2.2-2.4).
Prevalence of multimorbidity is lower among foreign-borns as compared with native-borns, but increases rapidly with length of residence in the host country. However, the progressive development of multimorbidity among immigrants varies widely depending on area of origin. These findings provide important insight into the health care needs of specific population groups and may help minimize the negative impact of multimorbidity among the most vulnerable groups.
多重疾病在基层医疗中是一个日益普遍的现象，了解社会决定因素对其演变的影响至关重要。本研究的目的是在考虑移民在东道国的居住时间和移民人口的原籍地区的情况下，了解多重疾病与移民之间的关系。
基于EpiChron队列的数据，对西班牙阿拉贡公共卫生服务机构登记的所有成年患者进行横断面回顾性研究（N = 1092279；144238人为外国出生）。计算多重疾病的年龄标准化患病率。进行了不同模型的二元逻辑回归，以研究多重疾病、移民身份和在东道国的居住时间之间的关联。
外国出生者患多重疾病的风险低于本国出生者[比值比（OR）：0.54，95%置信区间（CI）：0.53 - 0.55]。亚洲人（OR：0.34，95% CI：0.31 - 0.37）和东欧人（OR：0.42，95% CI：0.40 - 0.43）患多重疾病的概率最低，拉丁美洲人（OR：0.70，95% CI：0.68 - 0.72）最高。在阿拉贡居住≥5年的外国出生移民患多重疾病的风险高于居住<5年的移民（OR：2.3，95% CI：2.2 - 2.4）。
与本国出生者相比，外国出生者中多重疾病的患病率较低，但随着在东道国居住时间的延长而迅速上升。然而，移民中多重疾病的逐步发展因原籍地区而异。这些发现为特定人群的医疗保健需求提供了重要见解，并可能有助于将最弱势群体中多重疾病的负面影响降至最低。
