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Epidemiology of multimorbidity and implications for health care, research, and medical education

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Epidemiology of multimorbidity and implications for health care, research, and medical education : a cross-sectional study. / Barnett, Karen; Mercer, Stewart W; Norbury, Michael; Watt, Graham; Wyke, Sally; Guthrie, Bruce (Lead / Corresponding author).

In: Lancet, Vol. 380, No. 9836, 2012, p. 37-43.

Research output: Contribution to journalArticle

Harvard

Barnett, K, Mercer, SW, Norbury, M, Watt, G, Wyke, S & Guthrie, B 2012, 'Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study' Lancet, vol 380, no. 9836, pp. 37-43.

APA

Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet, 380(9836), 37-43doi: 10.1016/S0140-6736(12)60240-2

Vancouver

Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37-43.

Author

Barnett, Karen; Mercer, Stewart W; Norbury, Michael; Watt, Graham; Wyke, Sally; Guthrie, Bruce (Lead / Corresponding author) / Epidemiology of multimorbidity and implications for health care, research, and medical education : a cross-sectional study.

In: Lancet, Vol. 380, No. 9836, 2012, p. 37-43.

Research output: Contribution to journalArticle

Bibtex - Download

@article{1f0a7251962c4a08b3e2a4454611928b,
title = "Epidemiology of multimorbidity and implications for health care, research, and medical education",
author = "Karen Barnett and Mercer, {Stewart W} and Michael Norbury and Graham Watt and Sally Wyke and Bruce Guthrie",
note = "Copyright 2012 Elsevier B.V., All rights reserved.",
year = "2012",
volume = "380",
number = "9836",
pages = "37--43",
journal = "Lancet",
issn = "0140-6736",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Epidemiology of multimorbidity and implications for health care, research, and medical education

T2 - a cross-sectional study

A1 - Barnett,Karen

A1 - Mercer,Stewart W

A1 - Norbury,Michael

A1 - Watt,Graham

A1 - Wyke,Sally

A1 - Guthrie,Bruce

AU - Barnett,Karen

AU - Mercer,Stewart W

AU - Norbury,Michael

AU - Watt,Graham

AU - Wyke,Sally

AU - Guthrie,Bruce

PY - 2012

Y1 - 2012

N2 - BACKGROUND: Long-term disorders are the main challenge facing health-care systems worldwide, but health systems are largely configured for individual diseases rather than multimorbidity. We examined the distribution of multimorbidity, and of comorbidity of physical and mental health disorders, in relation to age and socioeconomic deprivation. METHODS: In a cross-sectional study we extracted data on 40 morbidities from a database of 1?751?841 people registered with 314 medical practices in Scotland as of March, 2007. We analysed the data according to the number of morbidities, disorder type (physical or mental), sex, age, and socioeconomic status. We defined multimorbidity as the presence of two or more disorders. FINDINGS: 42·2% (95% CI 42·1-42·3) of all patients had one or more morbidities, and 23·2% (23·08-23·21) were multimorbid. Although the prevalence of multimorbidity increased substantially with age and was present in most people aged 65 years and older, the absolute number of people with multimorbidity was higher in those younger than 65 years (210?500 vs 194?996). Onset of multimorbidity occurred 10-15 years earlier in people living in the most deprived areas compared with the most affluent, with socioeconomic deprivation particularly associated with multimorbidity that included mental health disorders (prevalence of both physical and mental health disorder 11·0%, 95% CI 10·9-11·2% in most deprived area vs 5·9%, 5·8%-6·0% in least deprived). The presence of a mental health disorder increased as the number of physical morbidities increased (adjusted odds ratio 6·74, 95% CI 6·59-6·90 for five or more disorders vs 1·95, 1·93-1·98 for one disorder), and was much greater in more deprived than in less deprived people (2·28, 2·21-2·32 vs 1·08, 1·05-1·11). INTERPRETATION: Our findings challenge the single-disease framework by which most health care, medical research, and medical education is configured. A complementary strategy is needed, supporting generalist clinicians to provide personalised, comprehensive continuity of care, especially in socioeconomically deprived areas. FUNDING: Scottish Government Chief Scientist Office.

AB - BACKGROUND: Long-term disorders are the main challenge facing health-care systems worldwide, but health systems are largely configured for individual diseases rather than multimorbidity. We examined the distribution of multimorbidity, and of comorbidity of physical and mental health disorders, in relation to age and socioeconomic deprivation. METHODS: In a cross-sectional study we extracted data on 40 morbidities from a database of 1?751?841 people registered with 314 medical practices in Scotland as of March, 2007. We analysed the data according to the number of morbidities, disorder type (physical or mental), sex, age, and socioeconomic status. We defined multimorbidity as the presence of two or more disorders. FINDINGS: 42·2% (95% CI 42·1-42·3) of all patients had one or more morbidities, and 23·2% (23·08-23·21) were multimorbid. Although the prevalence of multimorbidity increased substantially with age and was present in most people aged 65 years and older, the absolute number of people with multimorbidity was higher in those younger than 65 years (210?500 vs 194?996). Onset of multimorbidity occurred 10-15 years earlier in people living in the most deprived areas compared with the most affluent, with socioeconomic deprivation particularly associated with multimorbidity that included mental health disorders (prevalence of both physical and mental health disorder 11·0%, 95% CI 10·9-11·2% in most deprived area vs 5·9%, 5·8%-6·0% in least deprived). The presence of a mental health disorder increased as the number of physical morbidities increased (adjusted odds ratio 6·74, 95% CI 6·59-6·90 for five or more disorders vs 1·95, 1·93-1·98 for one disorder), and was much greater in more deprived than in less deprived people (2·28, 2·21-2·32 vs 1·08, 1·05-1·11). INTERPRETATION: Our findings challenge the single-disease framework by which most health care, medical research, and medical education is configured. A complementary strategy is needed, supporting generalist clinicians to provide personalised, comprehensive continuity of care, especially in socioeconomically deprived areas. FUNDING: Scottish Government Chief Scientist Office.

U2 - 10.1016/S0140-6736(12)60240-2

DO - 10.1016/S0140-6736(12)60240-2

M1 - Article

JO - Lancet

JF - Lancet

SN - 0140-6736

IS - 9836

VL - 380

SP - 37

EP - 43

ER -

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