20-year trends in multimorbidity by race/ethnicity among hospitalized patient populations in the United States

International Journal for Equity in Health

Research

Mursal A. Mohamud¹  Paul E. Ronksley²  James Wick³  Alexander A. Leung⁴  Gabriel E. Fabreau⁴  Marcello Tonelli⁴  David J.T. Campbell⁵ 

[1] Cumming School of Medicine, Undergraduate Medical Education, University of Calgary, Calgary, AB, Canada;Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;

关键词: Multimorbidity;    Race;    Ethnicity;    Hospitalization;    United States;   

DOI  :  10.1186/s12939-023-01950-2

 received in 2022-07-12, accepted in 2023-07-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe challenges presented by multimorbidity continue to rise in the United States. Little is known about how the relative contribution of individual chronic conditions to multimorbidity has changed over time, and how this varies by race/ethnicity. The objective of this study was to describe trends in multimorbidity by race/ethnicity, as well as to determine the differential contribution of individual chronic conditions to multimorbidity in hospitalized populations over a 20-year period within the United States.MethodsThis is a serial cross-sectional study using the Nationwide Inpatient Sample (NIS) from 1993 to 2012. We identified all hospitalized patients aged ≥ 18 years old with available data on race/ethnicity. Multimorbidity was defined as the presence of 3 or more conditions based on the Elixhauser comorbidity index. The relative change in the proportion of hospitalized patients with multimorbidity, overall and by race/ethnicity (Black, White, Hispanic, Asian/Pacific Islander, Native American) were tabulated and presented graphically. Population attributable fractions were estimated from modified Poisson regression models adjusted for sex, age, and insurance type. These fractions were used to describe the relative contribution of individual chronic conditions to multimorbidity over time and across racial/ethnic groups.ResultsThere were 123,613,970 hospitalizations captured within the NIS between 1993 and 2012. The prevalence of multimorbidity increased in all race/ethnic groups over the 20-year period, most notably among White, Black, and Native American populations (+ 29.4%, + 29.7%, and + 32.0%, respectively). In both 1993 and 2012, Black hospitalized patients had a higher prevalence of multimorbidity (25.1% and 54.8%, respectively) compared to all other race/ethnic groups. Native American populations exhibited the largest overall increase in multimorbidity (+ 32.0%). Furthermore, the contribution of metabolic diseases to multimorbidity increased, particularly among Hispanic patients who had the highest population attributable fraction values for diabetes without complications (15.0%), diabetes with complications (5.1%), and obesity (5.8%).ConclusionsFrom 1993 to 2012, the secular increases in the prevalence of multimorbidity as well as changes in the differential contribution of individual chronic conditions has varied substantially by race/ethnicity. These findings further elucidate the racial/ethnic gaps prevalent in multimorbidity within the United States.Prior presentationsPreliminary finding of this study were presented at the Society of General Internal Medicine (SGIM) Annual Conference, Washington, DC, April 21, 2017.

【 授权许可】

CC BY   
© The Author(s) 2023

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