Lakra Kulwant, Pandey Mamata, Meher Satyabrata, Panda Bimal K, Meher Raj K, Panigrahi Deepak, Kumar Chowdury Ravindra, Panda Sujata, Mahapatra Sanjay Kumar
Community Medicine, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, IND.
Multidisciplinary Research Unit, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, IND.
Cureus. 2024 Nov 29;16(11):e74752. doi: 10.7759/cureus.74752. eCollection 2024 Nov.
Background Multimorbidity and polypharmacy are common in older adults and pose a considerable challenge to the health and social care system. They are complex and interrelated concepts in geriatric care that require early detection and patient-centered shared decision-making by multidisciplinary, team-led comprehensive geriatric assessment (CGA) across all health and social care settings. The primary objective of this study is to investigate the economic burden of multimorbidity and polypharmacy among geriatric patients. Methodology A cross-sectional study was conducted from July 2021 to June 2022 involving a total of 470 male and female respondents aged more than 60 years. Five different departments of Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla were selected for the study. Data were collected by interviewing and clinically examining 470 randomly selected geriatric patients who came to different outpatient departments of VIMSAR, Burla. Statistical analysis was performed with SPSS software version 21.0 (IBM Corp., Armonk, NY, USA). P-values <0.05 were considered statistically significant. Results Of the 470 study participants, farming (126, 26.8%)and other (149, 31.7%) occupations were the maximum. Overall, 97 (20.6%) respondents belonged to the upper socioeconomic class, 148 (31.5%) to the upper middle class, 131 (27.9%) to the lower middle class, and 94 (20%) to the lower socioeconomic class. A single chronic disease was higher in respondents from the upper class at 87 (89.69%) and upper middle class at 128 (86.48%). Multimorbidity diseases were higher in the lower middle (28, 21.37%) and lower (24, 25.53%) income group patients. Diabetes was more common in males at 110 (30.81%) in comparison to females at 7 (6.19%). Hypertension was also higher in males at 90 (25.21%) compared to females at 21 (2.65%). Chronic kidney disease was seen in 41 (28.01%) males and 13 (11.50%) females. People with a smokeless tobacco habit (165, 35.11%) and a family history of diabetes (99, 21.06%) and hypertension (117, 24.89%) were suffering from single chronic diseases. Conclusions Multimorbidity has a high incidence in old age. It is associated with substantially higher healthcare utilization and social care costs among older adults in Odisha. With the incidence of multimorbidity rising, especially as the population ages, we require healthcare systems that are developing to deal with the rising challenges related to multimorbidity and the relevant healthcare and societal costs.
多种疾病并存和多重用药在老年人中很常见，给卫生和社会护理系统带来了巨大挑战。它们是老年护理中复杂且相互关联的概念，需要在所有卫生和社会护理环境中通过多学科、团队主导的综合老年评估（CGA）进行早期检测和以患者为中心的共同决策。本研究的主要目的是调查老年患者中多种疾病并存和多重用药的经济负担。
2021年7月至2022年6月进行了一项横断面研究，共涉及470名年龄超过60岁的男性和女性受访者。选择了位于伯勒的维尔·苏伦德拉·赛义德医学科学与研究学院（VIMSAR）的五个不同科室进行研究。通过对随机选择的470名前来VIMSAR伯勒分院不同门诊科室就诊的老年患者进行访谈和临床检查来收集数据。使用SPSS 21.0软件（美国纽约州阿蒙克市IBM公司）进行统计分析。P值<0.05被认为具有统计学意义。
在470名研究参与者中，从事农业（126人，26.8%）和其他职业（149人，31.7%）的人数最多。总体而言，97名（20.6%）受访者属于社会经济上层阶级，148名（31.5%）属于中上层阶级，131名（27.9%）属于中下层阶级，94名（20%）属于社会经济下层阶级。单一慢性病在社会经济上层阶级的受访者中占比更高，为87人（89.69%），在中上层阶级中为128人（86.48%）。多种疾病并存情况在中下层（28人，21.37%）和下层（24人，25.53%）收入组患者中更为常见。糖尿病在男性中更为常见，有110人（30.81%），而女性中只有7人（6.19%）。高血压在男性中也更高，有90人（25.21%），而女性中只有21人（2.65%）。慢性肾病在41名（28.01%）男性和13名（11.50%）女性中出现。有无烟烟草使用习惯的人（165人，35.11%）以及有糖尿病家族史（99人，21.06%）和高血压家族史（117人，24.89%）的人患有单一慢性病。
多种疾病并存在老年人群中发病率很高。在奥里萨邦，它与老年人更高的医疗保健利用率和社会护理成本密切相关。随着多种疾病并存情况的发生率上升，尤其是随着人口老龄化，我们需要不断发展的医疗保健系统来应对与多种疾病并存相关的日益增加的挑战以及相关的医疗保健和社会成本。
