Quinaz Romana Guilherme, Kislaya Irina, Salvador Mário Rui, Cunha Gonçalves Susana, Nunes Baltazar, Dias Carlos
Unidade de Saúde Pública Lisboa Norte. Agrupamento de Centros de Saúde de Lisboa Norte. Lisboa; Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Portugal.
Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Centro de Investigação em Saúde Pública (CISP). Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal.
Acta Med Port. 2019 Feb 1;32(1):30-37. doi: 10.20344/amp.11227.
The simultaneous presence of multiple chronic diseases in the same individual is recognized as an important public health problem. Patients with multimorbidity have greater healthcare needs, which represents a higher burden on health services. Although there is no consensual definition of this concept, multimorbidity is usually defined as the presence of two or more chronic diseases in the same patient. The existence of evidence regarding multimorbidity will lead to more efficient management and treatment of these patients.
In order to estimate the prevalence of multimorbidity and to identify the associated factors, a cross-sectional epidemiological study was developed based on data from the INSEF, a population-based survey conducted on a representative probability sample of the Portuguese population (n = 4911). The prevalence of multimorbidity was estimated for the total population and separately for men and women, stratified by age group, region, education and income. The magnitudes of the associations were measured by the adjusted prevalence ratios calculated by the Poisson regression model.
Prevalence of multimorbidity was 38.3% (95% CI: 35.4% to 41.3%), with higher frequency in women, older people, Lisbon and Tagus Valley; Northern Portugal; Algarve and Alentejo regions and in those with lower academic qualifications. No association was found between multimorbidity and income.
Multimorbidity affects more than one third of the Portuguese population. Epidemiological data about multimorbidity in Portugal allows the identification of population groups with higher multimorbidity prevalence.
Our results, which highlight the greater risk of multimorbidity among older and less instructed people, are in line with the literature. These results show the relevance of multimorbidity patients and are especially important in the way how healthcare is organized and provided.
同一个体同时存在多种慢性疾病被视为一个重要的公共卫生问题。患有多种疾病的患者有更大的医疗需求，这给卫生服务带来了更高的负担。尽管对于这一概念尚无统一的定义，但多种疾病通常被定义为同一患者存在两种或更多种慢性疾病。关于多种疾病的证据的存在将有助于对这些患者进行更有效的管理和治疗。
为了估计多种疾病的患病率并确定相关因素，基于来自INSEF的数据开展了一项横断面流行病学研究，INSEF是对葡萄牙人口的代表性概率样本（n = 4911）进行的一项基于人群的调查。估计了总人口以及按年龄组、地区、教育程度和收入分层的男性和女性的多种疾病患病率。关联强度通过泊松回归模型计算的调整患病率比来衡量。
多种疾病的患病率为38.3%（95%置信区间：35.4%至41.3%），女性、老年人、里斯本和塔霍河谷地区、葡萄牙北部、阿尔加维和阿连特茹地区以及学历较低者的患病率更高。未发现多种疾病与收入之间存在关联。
多种疾病影响了超过三分之一的葡萄牙人口。葡萄牙关于多种疾病的流行病学数据有助于识别多种疾病患病率较高的人群组。
我们的结果突出了老年人和受教育程度较低者患多种疾病的风险更高，这与文献一致。这些结果显示了患有多种疾病的患者的相关性，并且在医疗保健的组织和提供方式方面尤为重要。
