Chukwusa Emeka, Font-Gilabert Paulino, Manthorpe Jill, Healey Andrew
Cicely Saunders Institute, King's College London, London, UK.
Health Services and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, The David Goldberg Centre, King's College London, London, UK.
J Multimorb Comorb. 2023 Oct 27;13:26335565231208994. doi: 10.1177/26335565231208994. eCollection 2023 Jan-Dec.
Multiple long-term health conditions (MLTCs) are common and increasing among older people, yet there is limited understanding of their prevalence and association with social care expenditure.
To estimate the prevalence of MTLCs and association with English social care expenditure.
Our study population included those aged ≥ 65 who died in England in the year 2018 with any of the following long-term conditions recorded on their death certificate: diabetes; cardiovascular diseases (CVDs) including hypertension; dementia; stroke; respiratory; and chronic kidney diseases (CKDs). Prevalence was based on the proportion of death reported for older people with MTLCs (≥ 2) in each of the 152 English Local Authorities (LAs). Ordinary least square regression (OLS) was used to assess the relationship between prevalence of MTLCs and adult social care expenditure, adjusting for LA characteristics.
Of the 409551 deaths reported, 19.9% (n = 81395) had ≥ 2 MTLCs, of which the combination of CVDs-diabetes was the most prevalent. Hospitals were the leading place of death for those with MTLCs. Results from the OLS regression model showed that an increased prevalence of MLTCs is associated with higher LA social care expenditure. A percentage point increase in prevalence of MLTCs is associated with an increase of about £8.13 in per capita LA social care expenditure.
Our findings suggest that the increased prevalence of MTLCs is associated with increased LA social care expenditure. It is important for future studies to further explore the mechanisms or link between LA social care expenditure and the prevalence of MTLCs.
多种长期健康状况（MLTCs）在老年人中很常见且呈上升趋势，但对其患病率以及与社会护理支出的关联了解有限。
估计MLTCs的患病率及其与英国社会护理支出的关联。
我们的研究人群包括2018年在英国死亡、年龄≥65岁且死亡证明上记录有以下任何一种长期疾病的人群：糖尿病；心血管疾病（CVDs），包括高血压；痴呆；中风；呼吸系统疾病；以及慢性肾脏病（CKDs）。患病率基于152个英国地方当局（LAs）中报告患有多种长期健康状况（≥2种）的老年人的死亡比例。使用普通最小二乘法回归（OLS）来评估MLTCs患病率与成人社会护理支出之间的关系，并对地方当局的特征进行调整。
在报告的409551例死亡中，19.9%（n = 81395）患有≥2种MLTCs，其中CVDs与糖尿病的组合最为常见。医院是患有MLTCs者的主要死亡场所。OLS回归模型的结果表明，MLTCs患病率的增加与地方当局更高的社会护理支出相关。MLTCs患病率每增加一个百分点，人均地方当局社会护理支出约增加8.13英镑。
我们的研究结果表明，MLTCs患病率的增加与地方当局社会护理支出的增加相关。未来的研究进一步探索地方当局社会护理支出与MLTCs患病率之间的机制或联系很重要。
