Abstract
BackgroundMultimorbidity is the co-occurrence of two or more chronic diseases.ObjectiveThis study, based on self-reported medical diagnosis, aims to investigate the dynamic distribution of multimorbidity across sociodemographic levels and its impacts on health-related issues over 15 years in Brazil using national data.MethodsData were analyzed using descriptive statistics, hypothesis tests, and logistic regression. The study sample comprised 679,572 adults (18-59 years of age) and 115,699 elderly people (≥60 years of age) from the two latest cross-sectional, multiple-cohort, national-based studies: the National Sample Household Survey (PNAD) of 1998, 2003, and 2008, and the Brazilian National Health Survey (PNS) of 2013.ResultsOverall, the risk of multimorbidity in adults was 1.7 times higher in women (odds ratio [OR] 1.73, 95% CI 1.67-1.79) and 1.3 times higher among people without education (OR 1.34, 95% CI 1.28-1.41). Multiple chronic diseases considerably increased with age in Brazil, and people between 50 and 59 years old were about 12 times more likely to have multimorbidity than adults between 18 and 29 years of age (OR 11.89, 95% CI 11.27-12.55). Seniors with multimorbidity had more than twice the likelihood of receiving health assistance in community services or clinics (OR 2.16, 95% CI 2.02-2.31) and of being hospitalized (OR 2.37, 95% CI 2.21-2.56). The subjective well-being of adults with multimorbidity was often worse than people without multiple chronic diseases (OR=12.85, 95% CI: 12.07-13.68). These patterns were similar across all 4 cohorts analyzed and were relatively stable over 15 years.ConclusionsOur study shows little variation in the prevalence of the multimorbidity of chronic diseases in Brazil over time, but there are differences in the prevalence of multimorbidity across different social groups. It is hoped that the analysis of multimorbidity from the two latest Brazil national surveys will support policy making on epidemic prevention and management.
Highlights
It is estimated that around 70% of all deaths worldwide are caused by noncommunicable diseases (NCDs), mainly cardiovascular diseases (31%), cancers (16%), chronic respiratory diseases (7%), and diabetes (3%) [1]
Our study developed statistical analysis to explore the possible nonclinical risk factors associated with the prevalence of multimorbidity
18.3% of the participants had 2 or more NCDs in Brazil, and the prevalence of multimorbidity varied between 17.1% and 21% over the 15 years of this study from 1998 to 2013
Summary
It is estimated that around 70% of all deaths worldwide are caused by noncommunicable diseases (NCDs), mainly cardiovascular diseases (31%), cancers (16%), chronic respiratory diseases (7%), and diabetes (3%) [1]. There is little evidence on which to base the incidence of multimorbidity of chronic NCDs using multiple cohorts of data for Brazil. Multiple chronic diseases considerably increased with age in Brazil, and people between 50 and 59 years old were about 12 times more likely to have multimorbidity than adults between 18 and 29 years of age (OR 11.89, 95% CI 11.27-12.55). The subjective well-being of adults with multimorbidity was often worse than people without multiple chronic diseases (OR=12.85, 95% CI: 12.07-13.68). These patterns were similar across all 4 cohorts analyzed and were relatively stable over 15 years. It is hoped that the analysis of multimorbidity from the two latest Brazil national surveys will support policy making on epidemic prevention and management
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