Prevalence of Multimorbidity of Chronic Noncommunicable Diseases in Brazil: Population-Based Study

医学 多发病率 逻辑回归 人口学 队列 优势比 横断面研究 描述性统计 可能性 人口 老年学 队列研究 公共卫生 环境卫生 内科学 病理 社会学 统计 护理部 数学
作者
Xin Shi,Simone Maria da Silva Lima,Caroline Maria de Miranda Mota,Ying Lü,Randall S. Stafford,Corintho Viana Pereira
出处
期刊:JMIR public health and surveillance [JMIR Publications Inc.]
卷期号:7 (11): e29693-e29693 被引量:16
标识
DOI:10.2196/29693
摘要

Background Multimorbidity is the co-occurrence of two or more chronic diseases. Objective This 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. Methods Data 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. Results Overall, 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. Conclusions Our 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.

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