ICMR-Regional Medical Research Centre, Bhubaneswar 751023, India.
The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia.
Int J Environ Res Public Health. 2022 Jul 26;19(15):9091. doi: 10.3390/ijerph19159091.
Complex multimorbidity refers to the co-occurrence of three or more chronic illnesses across >2 body systems, which may identify persons in need of additional medical support and treatment. There is a scarcity of evidence on the differences in patient outcomes between non-complex (≥2 conditions) and complex multimorbidity groups. We evaluated the prevalence and patient outcomes of complex multimorbidity and compared them to non-complex multimorbidity. We included 30,489 multimorbid individuals aged ≥45 years from the Longitudinal Ageing Study in India (LASI) from wave-1 conducted in 2017−2018. We employed a log link in generalised linear models (GLM) to identify possible risk factors presenting the adjusted prevalence−risk ratio (APRR) and adjusted prevalence−risk difference (APRD) with 95% confidence interval. The prevalence of complex multimorbidity was 34.5% among multimorbid individuals. Participants residing in urban areas [APRR: 1.10 (1.02, 1.20)], [APRD: 0.04 (0.006, 0.07)] were more likely to report complex multimorbidity. Participants with complex multimorbidity availed significantly higher inpatient department services and had higher expenditure as compared to the non-complex multimorbidity group. Our findings have major implications for healthcare systems in terms of meeting the requirements of people with complicated multimorbidity, as they have significantly higher inpatient health service utilisation, higher medical costs, and poorer self-rated health.
复杂的多种疾病是指两个以上身体系统同时存在三种或三种以上的慢性疾病，这可能表明患者需要额外的医疗支持和治疗。关于非复杂（≥2 种疾病）和复杂多种疾病患者结局之间的差异，证据有限。我们评估了复杂多种疾病的患病率和患者结局，并将其与非复杂多种疾病进行了比较。我们纳入了 2017-2018 年印度纵向老龄化研究（LASI）第 1 波中年龄≥45 岁的 30489 例多种疾病患者。我们采用广义线性模型（GLM）中的对数链接来确定可能的风险因素，以呈现调整后的患病率-风险比（APRR）和调整后的患病率-风险差异（APRD），置信区间为 95%。在多种疾病患者中，复杂多种疾病的患病率为 34.5%。居住在城市地区的参与者[APRR：1.10（1.02，1.20）]、[APRD：0.04（0.006，0.07）]更有可能报告复杂多种疾病。与非复杂多种疾病组相比，复杂多种疾病患者的住院部门服务利用率显著更高，支出也更高。我们的研究结果在医疗保健系统方面具有重要意义，因为它们需要满足患有复杂多种疾病的人群的需求，这些患者的住院卫生服务利用率更高，医疗费用更高，自我评估健康状况更差。
