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Social disparities in the prevalence of multimorbidity - A register-based population study:A register-based population study

机译:多发病率普遍存在的社会差异 - 基于登记的人口研究:基于登记的人口研究

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摘要

Prevalences of multimorbidity vary between European studies and several methods and definitions are used. In this study we examine the prevalence of multimorbidity in relation to age, gender and educational attainment and the association between physical and mental health conditions and educational attainment in a Danish population. A cross-sectional design was used to study the prevalence of multimorbidity, defined as two or more chronic conditions, and of comorbid physical and mental health conditions across age groups and educational attainment levels among 1,397,173 individuals aged 16 years and older who lived in the Capital Region of Denmark on January 1st, 2012. After calculating prevalence, odds ratios for multimorbidity and mental health conditions were derived from logistic regression on gender, age, age squared, education and number of physical conditions (only for odds ratios for mental health conditions). Odds ratios for having multimorbidity and mental health conditions for each variable were adjusted for all other variables. Multimorbidity prevalence was 21.6%. Half of the population aged 65 and above had multimorbidity, and prevalence was inversely related to educational attainment: 26.9% (95% CI, 26.8-26.9) among those with lower secondary education versus 13.5% (95% CI, 13.5-13.6) among people with postgraduate education. Adjusted odds ratios for multimorbidity were 0.50 (95% CI, 0.49-0.51) for people with postgraduate education, compared to people with lower secondary education. Among all population members, 4.9% (95% CI, 4.9-4.9) had both a physical and a mental health condition, a proportion that increased to 22.6% of people with multimorbidity. Physical and mental health comorbidity was more prevalent in women (6.33%; 95% CI, 6.3-6.4) than men (3.34%; 95% CI, 3.3-3.4) and approximately 50 times more prevalent among older persons than younger ones. Physical and mental health comorbidity was also twice as prevalent among people with lower secondary education than among those with postgraduate education. The presence of a mental health condition was strongly associated with the number of physical conditions; those with five or more physical conditions had an adjusted odds ratio for a mental health condition of 3.93 (95% CI, 3.8-4.1), compared to those with no physical conditions. Multimorbidity prevalence and patterns in the Danish population are comparable to those of other European populations. The high prevalence of mental and physical health conditions highlights the need to ensure that healthcare systems deliver care that takes physical and mental comorbidity into account. Further, the higher prevalence of multimorbidity among persons with low educational attainment emphasizes the importance of having a health care system providing care that is beneficial to all regardless of socioeconomic status.
机译:在欧洲的研究中,多发病的发生率有所不同,并且使用了几种方法和定义。在这项研究中,我们研究了丹麦人群中与年龄,性别和受教育程度相关的多发病率的流行,以及身心健康状况与受教育程度之间的关联。横断面设计用于研究居住在首都的1,397,173岁年龄段的1,397,173个人中跨年龄段和教育水平的多发病率(定义为两个或多个慢性病)和共病的身心健康状况丹麦地区,2012年1月1日。在计算患病率后,通过性别,年龄,年龄平方,教育程度和身体状况的数量的逻辑回归得出多发病率和精神健康状况的优势比(仅针对精神健康状况的优势比) 。对于所有其他变量,调整了每个变量具有多发病率和精神健康状况的几率。多发病率是21.6%。 65岁及以上人口中有一半患有多种疾病,其患病率与受教育程度呈反相关:初中文化程度的患病率为26.9%(95%CI,26.8-26.9),而中等教育程度的患病率为13.5%(95%CI,13.5-13.6)有研究生学历的人。与低中学历的人相比,研究生学历的多重发病率调整后的优势比为0.50(95%CI,0.49-0.51)。在所有人口成员中,有4.9%的人(95%CI,4.9-4.9)患有身体和精神疾病,这一比例增加到多发病者的22.6%。女性(6.33%; 95%CI,6.3-6.4)的身体和精神健康合并症比男性(3.34%; 95%CI,3.3-3.4)的患病率更高,而老年人中的患病率比年轻人高约50倍。初中文化程度者的身体和心理健康合并症也比研究生程度者为两倍。精神健康状况的存在与身体状况的数量密切相关;与那些没有身体状况的人相比,那些具有五个以上身体状况的人在精神健康状况下的调整优势比为3.93(95%CI,3.8-4.1)。丹麦人群的多发病率和发病模式与其他欧洲人群相当。精神和身体健康状况的普遍存在凸显了确保医疗保健系统提供考虑到身体和精神合并症的护理的必要性。此外,受教育程度低的人中的多发病率更高,这强调了拥有医疗保健系统提供对所有人有益的医疗服务的重要性,无论其社会经济地位如何。

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