Department of Global Health, School of Public Health, Peking University, Beijing, China.
Department of Sociology, Peking University, Beijing, China.
Geriatr Gerontol Int. 2018 Oct;18(10):1447-1452. doi: 10.1111/ggi.13510. Epub 2018 Sep 4.
The knowledge on multimorbidity and its impact on healthcare systems is lacking in low- and middle-income countries. We aimed to estimate the prevalence of multimorbidity, and analyze the health service use of middle-aged and older persons with multimorbidity in urban China.
Study participants included 3737 urban residents aged ≥45 years from the China Health and Retirement Longitudinal Study 2011. A total of 16 pre-specified self-reported chronic conditions were used to measure multimorbidity, which was defined as having two or more conditions. Logistic regression was used to analyze the characteristics and health service use of persons with multimorbidity. Analyses were weighted to adjust for sampling design and non-response.
Of the study population, 51.9% were men and 20.1% were aged >70 years. Hypertension (33.1%) was the most prevalent condition, followed by arthritis (25.4%), digestive disease (18.7%), dyslipidemia (18.3%) and heart disease (17.7%). The prevalence of multimorbidity was 45.5% (95% CI 41.4-49.7%). Multivariate analyses showed that the prevalence of multimorbidity was significantly higher in respondents who are older and socioeconomically disadvantaged than that in their counterparts. Multimorbid patients used 72.7% of outpatient services and 77.3% of inpatient services. After controlling for demographic, socioeconomic, health behavior and health insurance factors, condition counts still had a positive relationship with outpatient or inpatient service use.
The burden of multimorbidity is high among the middle-aged and older urban Chinese population. Management of multimorbidity therefore deserves more attention from health policymakers, providers and educators of health professionals in China and in other low- and middle-income countries. Geriatr Gerontol Int 2018; 18: 1447-1452.
中低收入国家对多种疾病及其对医疗体系的影响的了解有限。本研究旨在评估中国城市中年和老年人多种疾病的患病率，并分析患有多种疾病的人群的卫生服务利用情况。
本研究纳入了中国健康与退休纵向研究 2011 年的 3737 名年龄≥45 岁的城市居民。使用 16 种预先指定的自我报告的慢性疾病来衡量多种疾病，定义为患有两种或两种以上疾病。采用 logistic 回归分析患有多种疾病人群的特征和卫生服务利用情况。分析结果经过加权处理以调整抽样设计和无应答情况。
研究人群中，51.9%为男性，20.1%年龄>70 岁。最常见的疾病是高血压（33.1%），其次是关节炎（25.4%）、消化系统疾病（18.7%）、血脂异常（18.3%）和心脏病（17.7%）。多种疾病的患病率为 45.5%（95%CI 41.4-49.7%）。多变量分析显示，年龄较大和社会经济地位较低的受访者中，多种疾病的患病率显著高于其他受访者。多种疾病患者使用了 72.7%的门诊服务和 77.3%的住院服务。在控制人口统计学、社会经济、健康行为和健康保险因素后，疾病数量与门诊或住院服务的使用仍呈正相关。
中国城市中年和老年人群的多种疾病负担沉重。因此，卫生政策制定者、提供者以及中国和其他中低收入国家的卫生专业人员教育者应更加关注多种疾病的管理。
