Abstract
IntroductionHealthcare management is oriented toward single diseases, yet multimorbidity is nevertheless the rule and there is a tendency for certain diseases to occur in clusters. This study sought to identify comorbidity patterns in patients with chronic diseases, by reference to number of comorbidities, age and sex, in a population receiving medical care from 129 general practitioners in Spain, in 2007.MethodsA cross-sectional study was conducted in a health-area setting of the Madrid Autonomous Region (Comunidad Autónoma), covering a population of 198,670 individuals aged over 14 years. Multiple correspondences were analyzed to identify the clustering patterns of the conditions targeted.ResultsForty-two percent (95% confidence interval [CI]: 41.8–42.2) of the registered population had at least one chronic condition. In all, 24.5% (95% CI: 24.3–24.6) of the population presented with multimorbidity.In the correspondence analysis, 98.3% of the total information was accounted for by three dimensions. The following four, age- and sex-related comorbidity patterns were identified: pattern B, showing a high comorbidity rate; pattern C, showing a low comorbidity rate; and two patterns, A and D, showing intermediate comorbidity rates.ConclusionsFour comorbidity patterns could be identified which grouped diseases as follows: one showing diseases with a high comorbidity burden; one showing diseases with a low comorbidity burden; and two showing diseases with an intermediate comorbidity burden.
Highlights
Healthcare management is oriented toward single diseases, yet multimorbidity is the rule and there is a tendency for certain diseases to occur in clusters
Individuals with multimorbidity register a higher mortality rate [9], occasion higher healthcare costs, and have: a higher risk of hospital admissions which, as ambulatory care sensitive conditions (ACSC), would otherwise be preventable [5]; a poorer perception of their physical and mental health; a poorer quality of life [10]; and a diminished functional capacity [11]. This is a challenge for general practitioners (GPs), who are tasked with treating patients rather than specific diseases
42% had at least one chronic condition
Summary
Healthcare management is oriented toward single diseases, yet multimorbidity is the rule and there is a tendency for certain diseases to occur in clusters. Individuals with multimorbidity register a higher mortality rate [9], occasion higher healthcare costs, and have: a higher risk of hospital admissions which, as ambulatory care sensitive conditions (ACSC), would otherwise be preventable [5]; a poorer perception of their physical and mental health; a poorer quality of life [10]; and a diminished functional capacity [11]. This is a challenge for GPs, who are tasked with treating patients rather than specific diseases. The result is that the whole is greater than the sum of the parts and [12], in view of its incidence and socioeconomic impact, multimorbidity constitutes a challenge to healthcare services in the 21st century [13]
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