Pati Sanghamitra, Sinha Rajeshwari, Panda Meely, Puri Parul, Pati Sandipana
ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India.
Independent Researcher, New Delhi, India.
J Family Med Prim Care. 2021 Aug;10(8):2900-2914. doi: 10.4103/jfmpc.jfmpc_2436_20. Epub 2021 Aug 27.
Multimorbidity, the co-occurrence of two or more long-term conditions (LTC) in individuals, is associated with greater healthcare utilization, expenditure, and premature mortality, thus positing a challenge for patients and healthcare providers. Given its sparsely available epidemiological evidence, we aimed to describe the profile of multimorbidity in a representative sample of public healthcare outpatients in India.
A facility-based cross-sectional study was conducted from 1 July to 31 December 2015 in Odisha, India. Fifteen public healthcare facilities were selected by stratified random sampling. Data was collected from 1,870 adult outpatients attending these settings using Multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC) tool.
Nearly 3/4 of both women and men outpatients were either obese or overweight. >1/2 had multimorbidity (≥2 LTC) while 1/3 had ≥3 LTC. Most prevalent condition was hypertension (63%), followed by chronic backache and arthritis. Cancer and psychiatric illness were least reported. Multimorbidity increased with age group, socioeconomic status, and education level. Females across all age groups had higher reported multimorbidity than males. Diabetes--hypertension was frequently occurring dyad. Both physical and mental component of quality of life was reduced in multimorbidity.
Multimorbidity is becoming a norm in healthcare practice with high prevalence in females and older adults. Health services for non-communicable diseases need to include commonly occurring dyads along with health promotion. Higher prevalence in females reinforces the need to incorporate gender differences while studying multimorbidity. Analysis of multimorbidity epidemiology through an equity lens could illuminate the underpinning complexities and heterogeneities of this phenomenon.
多病共存是指个体同时患有两种或更多的长期疾病（LTC），与更高的医疗保健利用率、支出和过早死亡相关，因此给患者和医疗保健提供者带来了挑战。鉴于其流行病学证据稀少，我们旨在描述印度公共医疗门诊患者代表性样本中的多病共存情况。
2015年7月1日至12月31日在印度奥里萨邦进行了一项基于机构的横断面研究。通过分层随机抽样选择了15个公共医疗设施。使用初级保健多病共存评估问卷（MAQ-PC）工具从1870名在这些机构就诊的成年门诊患者中收集数据。
近四分之三的女性和男性门诊患者肥胖或超重。超过一半的人患有多病共存（≥2种长期疾病），而三分之一的人患有≥3种长期疾病。最常见的疾病是高血压（63%），其次是慢性背痛和关节炎。癌症和精神疾病的报告最少。多病共存随着年龄组、社会经济地位和教育水平的增加而增加。所有年龄组的女性报告的多病共存情况均高于男性。糖尿病-高血压是常见的二元组合。多病共存患者的生活质量的身体和心理成分均有所下降。
多病共存正成为医疗实践中的一种常态，在女性和老年人中患病率很高。非传染性疾病的卫生服务需要包括常见的二元组合以及健康促进。女性中较高的患病率强化了在研究多病共存时纳入性别差异的必要性。通过公平视角分析多病共存流行病学可以阐明这一现象的潜在复杂性和异质性。
