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Epidemiology, mortality, and health service use of local-level multimorbidity patterns in South Spain

Author

Listed:
  • Javier Alvarez-Galvez

    (University of Cadiz
    University Institute for Sustainable Social Development, University of Cádiz
    Hospital Puerta del Mar)

  • Esther Ortega-Martin

    (University of Cadiz
    University Institute for Sustainable Social Development, University of Cádiz)

  • Begoña Ramos-Fiol

    (University of Cadiz
    University Institute for Sustainable Social Development, University of Cádiz)

  • Victor Suarez-Lledo

    (University Institute for Sustainable Social Development, University of Cádiz
    University of Granada)

  • Jesus Carretero-Bravo

    (University of Cadiz
    University Institute for Sustainable Social Development, University of Cádiz)

Abstract

Multimorbidity –understood as the occurrence of chronic diseases together– represents a major challenge for healthcare systems due to its impact on disability, quality of life, increased use of services and mortality. However, despite the global need to address this health problem, evidence is still needed to advance our understanding of its clinical and social implications. Our study aims to characterise multimorbidity patterns in a dataset of 1,375,068 patients residing in southern Spain. Combining LCA techniques and geographic information, together with service use, mortality, and socioeconomic data, 25 chronicity profiles were identified and subsequently characterised by sex and age. The present study has led us to several findings that take a step forward in this field of knowledge. Specifically, we contribute to the identification of an extensive range of at-risk groups. Moreover, our study reveals that the complexity of multimorbidity patterns escalates at a faster rate and is associated with a poorer prognosis in local areas characterised by lower socioeconomic status. These results emphasize the persistence of social inequalities in multimorbidity, highlighting the need for targeted interventions to mitigate the impact on patients’ quality of life, healthcare utilisation, and mortality rates.

Suggested Citation

  • Javier Alvarez-Galvez & Esther Ortega-Martin & Begoña Ramos-Fiol & Victor Suarez-Lledo & Jesus Carretero-Bravo, 2023. "Epidemiology, mortality, and health service use of local-level multimorbidity patterns in South Spain," Nature Communications, Nature, vol. 14(1), pages 1-16, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-43569-5
    DOI: 10.1038/s41467-023-43569-5
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    References listed on IDEAS

    as
    1. Caroline A Jackson & Annette J Dobson & Leigh R Tooth & Gita D Mishra, 2016. "Lifestyle and Socioeconomic Determinants of Multimorbidity Patterns among Mid-Aged Women: A Longitudinal Study," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-16, June.
    2. Bomi Park & Hye Ah Lee & Hyesook Park, 2019. "Use of latent class analysis to identify multimorbidity patterns and associated factors in Korean adults aged 50 years and older," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-13, November.
    3. Jianxing Yu & Fangying Song & Yingying Li & Zhou Zheng & Huanhuan Jia & Yuzhe Sun & Lina Jin & Xihe Yu, 2020. "Multimorbidity Analysis of 13 Systemic Diseases in Northeast China," IJERPH, MDPI, vol. 17(6), pages 1-12, March.
    4. Linzer, Drew A. & Lewis, Jeffrey B., 2011. "poLCA: An R Package for Polytomous Variable Latent Class Analysis," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 42(i10).
    5. Jesús Carretero-Bravo & Begoña Ramos-Fiol & Esther Ortega-Martín & Víctor Suárez-Lledó & Alejandro Salazar & Cristina O’Ferrall-González & María Dueñas & Juan Luis Peralta-Sáez & Juan Luis González-Ca, 2022. "Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(24), pages 1-17, December.
    6. Kathryn Fisher & Lauren E Griffith & Andrea Gruneir & David Kanters & Maureen Markle-Reid & Jenny Ploeg, 2021. "Functional limitations in people with multimorbidity and the association with mental health conditions: Baseline data from the Canadian Longitudinal Study on Aging (CLSA)," PLOS ONE, Public Library of Science, vol. 16(8), pages 1-21, August.
    7. Davide L. Vetrano & Albert Roso-Llorach & Sergio Fernández & Marina Guisado-Clavero & Concepción Violán & Graziano Onder & Laura Fratiglioni & Amaia Calderón-Larrañaga & Alessandra Marengoni, 2020. "Twelve-year clinical trajectories of multimorbidity in a population of older adults," Nature Communications, Nature, vol. 11(1), pages 1-9, December.
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