Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country
Multimorbidity is a growing health care problem in aging societies and is strongly associated with epidemiologic characteristics and sociodemographic factors. Knowledge of these associations is important for the design of effective preventive and management strategies. To determine the association b...
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description | Multimorbidity is a growing health care problem in aging societies and is strongly associated with epidemiologic characteristics and sociodemographic factors. Knowledge of these associations is important for the design of effective preventive and management strategies.
To determine the association between multimorbidity and sociodemographic factors (age, socioeconomic status [SES], sex, and race/ethnicity) and the association between mental health diseases and physical diseases, as well as their implications for the types and costs of health care use.
This population-based cross-sectional study used deidentified Singapore Eastern Regional Health System data collected between January 1, 2012, and December 31, 2016. Patients who were alive as of January 1, 2016, and residing in the Regional Health System region in 2016 (N = 1 181 024) were included. Patients who had no year of birth records (n = 573), were born in 2017 (n = 93), or died before January 1, 2016 (n = 47 322), were excluded.
Multimorbidity, age, sex, SES, mental health, race/ethnicity, and health care use.
In the study population of 1 181 024 individuals, the mean (SD) age was 39.6 (22.1) years, 51.2% were women, 70.1% were Chinese, 7.1% were Indian, 13.5% were Malayan, and 9.3% were other races/ethnicities. Multimorbidity, present in 26.2% of the population, was more prevalent in female (26.8%; 95% CI, 26.7%-26.9%) than in male (25.6%; 95% CI, 25.5%-25.7%) patients and among patients with low SES (41.6%) than those with high SES (20.1%). Mental health diseases were significantly more prevalent among individuals with low SES (5.2%; 95% CI, 5.1%-5.2%) than high SES (2.1%; 95% CI, 2.0%-2.1%; P |
doi_str_mv | 10.1001/jamanetworkopen.2019.15245 |
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To determine the association between multimorbidity and sociodemographic factors (age, socioeconomic status [SES], sex, and race/ethnicity) and the association between mental health diseases and physical diseases, as well as their implications for the types and costs of health care use.
This population-based cross-sectional study used deidentified Singapore Eastern Regional Health System data collected between January 1, 2012, and December 31, 2016. Patients who were alive as of January 1, 2016, and residing in the Regional Health System region in 2016 (N = 1 181 024) were included. Patients who had no year of birth records (n = 573), were born in 2017 (n = 93), or died before January 1, 2016 (n = 47 322), were excluded.
Multimorbidity, age, sex, SES, mental health, race/ethnicity, and health care use.
In the study population of 1 181 024 individuals, the mean (SD) age was 39.6 (22.1) years, 51.2% were women, 70.1% were Chinese, 7.1% were Indian, 13.5% were Malayan, and 9.3% were other races/ethnicities. Multimorbidity, present in 26.2% of the population, was more prevalent in female (26.8%; 95% CI, 26.7%-26.9%) than in male (25.6%; 95% CI, 25.5%-25.7%) patients and among patients with low SES (41.6%) than those with high SES (20.1%). Mental health diseases were significantly more prevalent among individuals with low SES (5.2%; 95% CI, 5.1%-5.2%) than high SES (2.1%; 95% CI, 2.0%-2.1%; P < .001). The 3 most prevalent disease combinations were chronic kidney disease and hypertension, chronic kidney disease and lipid disorders, and hypertension and lipid disorders. Although chronic kidney disease, hypertension, lipid disorders, and type 1 and/or type 2 diabetes-related diseases had a low cost per capita, the large number of patients with these conditions caused the overall proportion of the cost incurred by health care use to be more than twice that incurred in other diseases.
These findings emphasize the association between multimorbidity and sociodemographic factors such as increasing age, lower SES, female sex, and increasing number of mental disorders. Health care policies need to take sociodemographic factors into account when tackling multimorbidity in a population.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2019.15245</identifier><identifier>PMID: 31722030</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Aging - physiology ; Comorbidity ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 - epidemiology ; Epidemiology - trends ; Ethnicity ; Health Status ; Humans ; Hypertension ; Hypertension - epidemiology ; Kidney diseases ; Lipids ; Logistic Models ; Mental disorders ; Mental Disorders - epidemiology ; Mental health ; Multimorbidity - trends ; Online Only ; Original Investigation ; Population ; Prevalence ; Public Health ; Singapore ; Social Class ; Sociodemographics</subject><ispartof>JAMA network open, 2019-11, Vol.2 (11), p.e1915245-e1915245</ispartof><rights>2019. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2019 Low LL et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a473t-f94914ff0d45eb6834c0f234f1b0bed8b69a735579f64258dffc1064d9a7474d3</citedby><cites>FETCH-LOGICAL-a473t-f94914ff0d45eb6834c0f234f1b0bed8b69a735579f64258dffc1064d9a7474d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,782,786,866,887,27931,27932</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31722030$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Low, Lian Leng</creatorcontrib><creatorcontrib>Kwan, Yu Heng</creatorcontrib><creatorcontrib>Ko, Michelle Shi Min</creatorcontrib><creatorcontrib>Yeam, Cheng Teng</creatorcontrib><creatorcontrib>Lee, Vivian Shu Yi</creatorcontrib><creatorcontrib>Tan, Wee Boon</creatorcontrib><creatorcontrib>Thumboo, Julian</creatorcontrib><title>Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>Multimorbidity is a growing health care problem in aging societies and is strongly associated with epidemiologic characteristics and sociodemographic factors. Knowledge of these associations is important for the design of effective preventive and management strategies.
To determine the association between multimorbidity and sociodemographic factors (age, socioeconomic status [SES], sex, and race/ethnicity) and the association between mental health diseases and physical diseases, as well as their implications for the types and costs of health care use.
This population-based cross-sectional study used deidentified Singapore Eastern Regional Health System data collected between January 1, 2012, and December 31, 2016. Patients who were alive as of January 1, 2016, and residing in the Regional Health System region in 2016 (N = 1 181 024) were included. Patients who had no year of birth records (n = 573), were born in 2017 (n = 93), or died before January 1, 2016 (n = 47 322), were excluded.
Multimorbidity, age, sex, SES, mental health, race/ethnicity, and health care use.
In the study population of 1 181 024 individuals, the mean (SD) age was 39.6 (22.1) years, 51.2% were women, 70.1% were Chinese, 7.1% were Indian, 13.5% were Malayan, and 9.3% were other races/ethnicities. Multimorbidity, present in 26.2% of the population, was more prevalent in female (26.8%; 95% CI, 26.7%-26.9%) than in male (25.6%; 95% CI, 25.5%-25.7%) patients and among patients with low SES (41.6%) than those with high SES (20.1%). Mental health diseases were significantly more prevalent among individuals with low SES (5.2%; 95% CI, 5.1%-5.2%) than high SES (2.1%; 95% CI, 2.0%-2.1%; P < .001). The 3 most prevalent disease combinations were chronic kidney disease and hypertension, chronic kidney disease and lipid disorders, and hypertension and lipid disorders. Although chronic kidney disease, hypertension, lipid disorders, and type 1 and/or type 2 diabetes-related diseases had a low cost per capita, the large number of patients with these conditions caused the overall proportion of the cost incurred by health care use to be more than twice that incurred in other diseases.
These findings emphasize the association between multimorbidity and sociodemographic factors such as increasing age, lower SES, female sex, and increasing number of mental disorders. Health care policies need to take sociodemographic factors into account when tackling multimorbidity in a population.</description><subject>Aging - physiology</subject><subject>Comorbidity</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Epidemiology - trends</subject><subject>Ethnicity</subject><subject>Health Status</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - epidemiology</subject><subject>Kidney diseases</subject><subject>Lipids</subject><subject>Logistic Models</subject><subject>Mental disorders</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental health</subject><subject>Multimorbidity - trends</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Population</subject><subject>Prevalence</subject><subject>Public Health</subject><subject>Singapore</subject><subject>Social Class</subject><subject>Sociodemographics</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkV1rFDEUhoMottT-BQl6482u-Z4ZL4RlaVWoCH7gZcjkYzbrTDImmcr-B3-0qa2l7lVCzvOck8MLwAuM1hgh_HqvJhVs-RXTjzjbsCYId2vMCeOPwCnhDVvRFvHHD-4n4DznPUKoorQT_Ck4obghBFF0Cn5fzN7YyccxDl7D7U4lpYtNPhevM4wOflzG4qeYem98OUAVDPwStY_VikNS865ql9WJKcNNzrWkijXwuy-7Y9cHqOBnVSeOB7gZfBiq4VWA27iEkg7PwBOnxmzP784z8O3y4uv2_erq07sP283VSrGGlpXrWIeZc8gwbnvRUqaRI5Q53KPemrYXnWoo503nBCO8Nc5pjAQz9Zk1zNAz8Pa277z0kzXa1uFqlHPyk0oHGZWX_1eC38khXkvRIdJ0rDZ4ddcgxZ-LzUVOPms7jjWauGRJKGZctKTlFX15hO7jkkJdTxJRESxwSyv15pbSKeacrLv_DEbyJnd5lLu8yV3-zb3Kzx-uc6_-S5n-AaAiskQ</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Low, Lian Leng</creator><creator>Kwan, Yu Heng</creator><creator>Ko, Michelle Shi Min</creator><creator>Yeam, Cheng Teng</creator><creator>Lee, Vivian Shu Yi</creator><creator>Tan, Wee Boon</creator><creator>Thumboo, Julian</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20191101</creationdate><title>Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country</title><author>Low, Lian Leng ; Kwan, Yu Heng ; Ko, Michelle Shi Min ; Yeam, Cheng Teng ; Lee, Vivian Shu Yi ; Tan, Wee Boon ; Thumboo, Julian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a473t-f94914ff0d45eb6834c0f234f1b0bed8b69a735579f64258dffc1064d9a7474d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aging - physiology</topic><topic>Comorbidity</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Epidemiology - trends</topic><topic>Ethnicity</topic><topic>Health Status</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - epidemiology</topic><topic>Kidney diseases</topic><topic>Lipids</topic><topic>Logistic Models</topic><topic>Mental disorders</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental health</topic><topic>Multimorbidity - trends</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Population</topic><topic>Prevalence</topic><topic>Public Health</topic><topic>Singapore</topic><topic>Social Class</topic><topic>Sociodemographics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Low, Lian Leng</creatorcontrib><creatorcontrib>Kwan, Yu Heng</creatorcontrib><creatorcontrib>Ko, Michelle Shi Min</creatorcontrib><creatorcontrib>Yeam, Cheng Teng</creatorcontrib><creatorcontrib>Lee, Vivian Shu Yi</creatorcontrib><creatorcontrib>Tan, Wee Boon</creatorcontrib><creatorcontrib>Thumboo, Julian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Low, Lian Leng</au><au>Kwan, Yu Heng</au><au>Ko, Michelle Shi Min</au><au>Yeam, Cheng Teng</au><au>Lee, Vivian Shu Yi</au><au>Tan, Wee Boon</au><au>Thumboo, Julian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>2</volume><issue>11</issue><spage>e1915245</spage><epage>e1915245</epage><pages>e1915245-e1915245</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>Multimorbidity is a growing health care problem in aging societies and is strongly associated with epidemiologic characteristics and sociodemographic factors. Knowledge of these associations is important for the design of effective preventive and management strategies.
To determine the association between multimorbidity and sociodemographic factors (age, socioeconomic status [SES], sex, and race/ethnicity) and the association between mental health diseases and physical diseases, as well as their implications for the types and costs of health care use.
This population-based cross-sectional study used deidentified Singapore Eastern Regional Health System data collected between January 1, 2012, and December 31, 2016. Patients who were alive as of January 1, 2016, and residing in the Regional Health System region in 2016 (N = 1 181 024) were included. Patients who had no year of birth records (n = 573), were born in 2017 (n = 93), or died before January 1, 2016 (n = 47 322), were excluded.
Multimorbidity, age, sex, SES, mental health, race/ethnicity, and health care use.
In the study population of 1 181 024 individuals, the mean (SD) age was 39.6 (22.1) years, 51.2% were women, 70.1% were Chinese, 7.1% were Indian, 13.5% were Malayan, and 9.3% were other races/ethnicities. Multimorbidity, present in 26.2% of the population, was more prevalent in female (26.8%; 95% CI, 26.7%-26.9%) than in male (25.6%; 95% CI, 25.5%-25.7%) patients and among patients with low SES (41.6%) than those with high SES (20.1%). Mental health diseases were significantly more prevalent among individuals with low SES (5.2%; 95% CI, 5.1%-5.2%) than high SES (2.1%; 95% CI, 2.0%-2.1%; P < .001). The 3 most prevalent disease combinations were chronic kidney disease and hypertension, chronic kidney disease and lipid disorders, and hypertension and lipid disorders. Although chronic kidney disease, hypertension, lipid disorders, and type 1 and/or type 2 diabetes-related diseases had a low cost per capita, the large number of patients with these conditions caused the overall proportion of the cost incurred by health care use to be more than twice that incurred in other diseases.
These findings emphasize the association between multimorbidity and sociodemographic factors such as increasing age, lower SES, female sex, and increasing number of mental disorders. Health care policies need to take sociodemographic factors into account when tackling multimorbidity in a population.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>31722030</pmid><doi>10.1001/jamanetworkopen.2019.15245</doi><oa>free_for_read</oa></addata></record> |
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subjects | Aging - physiology Comorbidity Cross-Sectional Studies Diabetes Mellitus, Type 2 - epidemiology Epidemiology - trends Ethnicity Health Status Humans Hypertension Hypertension - epidemiology Kidney diseases Lipids Logistic Models Mental disorders Mental Disorders - epidemiology Mental health Multimorbidity - trends Online Only Original Investigation Population Prevalence Public Health Singapore Social Class Sociodemographics |
title | Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country |
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