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Burden of multimorbidity in relation to age, gender and immigrant status: a cross-sectional study based on administrative data.

Burden of multimorbidity in relation to age, gender and immigrant status: a cross-sectional study based on administrative data.
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Lenzi J, Avaldi VM, Rucci P, Pieri G, Fantini MP,


Lenzi J, Avaldi VM, Rucci P, Pieri G, Fantini MP, (click to view)

Lenzi J, Avaldi VM, Rucci P, Pieri G, Fantini MP,

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BMJ open 2016 12 216(12) e012812 doi 10.1136/bmjopen-2016-012812

Abstract
OBJECTIVES
Many studies have investigated multimorbidity, whose prevalence varies according to settings and data sources. However, few studies on this topic have been conducted in Italy, a country with universal healthcare and one of the most aged populations in the world. The aim of this study was to estimate the prevalence of multimorbidity in a Northern Italian region, to investigate its distribution by age, gender and citizenship and to analyse the correlations of diseases.

DESIGN
Cross-sectional study based on administrative data.

SETTING
Emilia-Romagna, an Italian region with ∼4.4 million inhabitants, of which almost one-fourth are aged ≥65 years.

PARTICIPANTS
All adults residing in Emilia-Romagna on 31 December 2012. Hospitalisations, drug prescriptions and contacts with community mental health services from 2003 to 2012 were traced to identify the presence of 17 physical and 9 mental health disorders.

PRIMARY AND SECONDARY OUTCOME MEASURES
Descriptive analysis of differences in the prevalence of multimorbidity in relation to age, gender and citizenship. The correlations of diseases were analysed using exploratory factor analysis.

RESULTS
The study population included 622 026 men and 751 011women, with a mean age of 66.4 years. Patients with multimorbidity were 33.5% in 75 years and >60% among patients aged ≥90 years; among patients aged ≥65 years, the proportion of multimorbidity was 39.9%. After standardisation by age and gender, multimorbidity was significantly more frequent among Italian citizens than among immigrants. Factor analysis identified 5 multimorbidity patterns: (1) psychiatric disorders, (2) cardiovascular, renal, pulmonary and cerebrovascular diseases, (3) neurological diseases, (4) liver diseases, AIDS/HIV and substance abuse and (5) tumours.

CONCLUSIONS
Multimorbidity was highly prevalent in Emilia-Romagna and strongly associated with age. This finding highlights the need for healthcare providers to adopt individualised care plans and ensure continuity of care.

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