چکیده (انگلیسی):

Background:Concurrent diseases, multiple pathologies and multimorbidity patterns are topics of increased interest
as the world’s population ages. To explore the impact of multimorbidity on affected patients and the consequences
for health services, we designed a study to describe multimorbidity by sex and life-stage in a large population
sample and to assess the association with acute morbidity, area of residency and use of health services.
Methods:A cross-sectional study was conducted in Catalonia (Spain). Participants were 1,749,710 patients aged
19+ years (251 primary care teams). Primary outcome: Multimorbidity (≥2 chronic diseases). Secondary outcome:
Number of new events of each acute disease. Other variables: number of acute diseases per patient, sex, age group
(19–24, 25–44, 45–64, 65–79, and 80+ years), urban/rural residence, and number of visits during 2010.
Results:Multimorbidity was present in 46.8% (95% CI, 46.7%-46.8%) of the sample, and increased as age increased,
being higher in women and in rural areas. The most prevalent pair of chronic diseases was hypertension and lipid
disorders in patients older than 45 years. Infections (mainly upper respiratory infection) were the most common
acute diagnoses. In women, the highest significant RR of multimorbidity vs. non-multimorbidity was found for
teeth/gum disease (aged 19–24) and acute upper respiratory infection. In men, this RR was only positive and significant
for teeth/gum disease (aged 65–79). The adjusted analysis showed a strongly positive association with multimorbidity
for the oldest women (80+ years) with acute diseases and women aged 65–79with3ormoreacutediseases,
compared to patients with no acute diseases (OR ranged from 1.16 to 1.99, p < 0.001). Living in a rural area was
significantly associated with lower probability of having multimorbidity. The odds of multimorbidity increased
sharply as the number of visitsincreased, reaching the highest probability in those aged 65–79 years.
Conclusions:Multimorbidity is related to greater use of health care services and higher incidence of acute
diseases, increasing the burden on primary care services.The differences related to sex and life-stage observed for
multimorbidity and acute diseases suggest that further research on multimorbidity should be stratified according
to these factors.