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Burden of multimorbidity in relation to age, gender and immigrant status: a cross-sectional study based on administrative data
  1. Jacopo Lenzi,
  2. Vera Maria Avaldi,
  3. Paola Rucci,
  4. Giulia Pieri,
  5. Maria Pia Fantini
  1. Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
  1. Correspondence to Professor Maria Pia Fantini; mariapia.fantini{at}unibo.it

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.

  • EPIDEMIOLOGY
  • PRIMARY CARE
  • PUBLIC HEALTH

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Contributors JL and MPF made substantial contributions to the conception and design, analysis and interpretation of data, drafted the article and revised it critically for important intellectual content, and approved final version to be published. VMA, PR and MPF were responsible for interpretation of data, drafted the article and revised it critically for important intellectual content, and approved the final version to be published. GP was involved in conception and design, revised the article critically for important intellectual content, and approved the final version to be published. MPF is a guarantor for the study.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Statistical code and raw data are available by emailing mariapia.fantini@unibo.it.