Saavedra-Moreno Carolina, Hurtado Rafael, Velasco Nubia, Ramírez Andrea
Faculty of Engineering, Universidad Nacional de Colombia, Bogotá, Colombia.
Faculty of Engineering, Universidad de Ibagué, Ibagué, Colombia.
Glob Epidemiol. 2024 Oct 12;8:100171. doi: 10.1016/j.gloepi.2024.100171. eCollection 2024 Dec.
Multimorbidity has emerged as a challenge for health systems due to its association with adverse clinical outcomes. Given the limited information available on multimorbidity, particularly in low- and middle-income countries, this study characterizes multimorbidity patterns in the population of Bogotá, Colombia in 2018.
In a cross-sectional study, we analyzed 16 million medical consultation records from Bogotá reported in the National Service Delivery Records in 2018. Using network analysis, we quantified the prevalence of multimorbidity in the population and identified the most common associations between diagnoses, with data stratified by age, sex, and socioeconomic status.
The study found that the prevalence of multimorbidity in the population was 44.2 %, increased with age, and was higher in women and in people affiliated to the contributory health scheme. Allergies and vasomotor rhinitis with asthma were common in young people. In women aged 19-39 years, obesity with hypothyroidism was common, while men in the same age group had obesity with dyslipidemia. In people aged 60 years and older, essential hypertension with dyslipidemia was the most common. In addition, some associations between diagnoses showed a higher association in people affiliated to the subsidized health scheme, with notable associations with trauma, especially in men.
Overall, the results provide valuable insights into multimorbidity in the population and highlight inequalities based on sociodemographic factors. Future research should investigate whether the lower prevalence of multimorbidity in vulnerable groups is related to biases in data collection or to underlying inequalities in healthcare access.
由于多重疾病与不良临床结局相关联,它已成为卫生系统面临的一项挑战。鉴于关于多重疾病的可用信息有限,尤其是在低收入和中等收入国家,本研究对2018年哥伦比亚波哥大人群中的多重疾病模式进行了特征描述。
在一项横断面研究中,我们分析了2018年国家服务提供记录中报告的来自波哥大的1600万份医疗咨询记录。使用网络分析,我们量化了人群中多重疾病的患病率,并确定了诊断之间最常见的关联,数据按年龄、性别和社会经济地位分层。
研究发现,人群中多重疾病的患病率为44.2%,随年龄增长而增加,在女性和参加缴费型健康保险计划的人群中更高。过敏以及血管运动性鼻炎合并哮喘在年轻人中很常见。在19至39岁的女性中,肥胖合并甲状腺功能减退很常见,而同一年龄组的男性则是肥胖合并血脂异常。在60岁及以上的人群中,原发性高血压合并血脂异常最为常见。此外,一些诊断之间的关联在参加补贴型健康保险计划的人群中显示出更高的关联性,与创伤有显著关联,尤其是在男性中。
总体而言,研究结果为人群中的多重疾病提供了有价值的见解,并突出了基于社会人口学因素的不平等现象。未来的研究应调查弱势群体中多重疾病患病率较低是与数据收集偏差有关,还是与医疗服务可及性方面的潜在不平等有关。