Factors associated to multimorbidity in inpatient elderly according to sociodemographic characteristics, lifestyle and use of services
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Abstract
Introduction: Aging is a physiological process associated to decreased functional capacity and the presence of diseases, especially chronic noncommunicable diseases. Objective: To analyze the prevalence and factors associated to the multimorbidity of elderly in a teaching hospital, according to sociodemographic characteristics, lifestyle and use of services in the health care network. Methods: Descriptive and inferential cross-sectional study, conducted with 144 hospitalized patients 60 years of age or more, from January to June 2018, in a university hospital in the state of Paraná. Data were collected 30 days after hospital discharge by telephone interview. The dependent variable was the occurrence of multimorbidity and the independent variables were: sociodemographic characteristics, lifestyle and use of hospital health services. Logistic regression analysis was performed. Results: It was found that 55% of the elderly had multimorbidity. The elderly who were more chances to have multimorbidity where there low education (OR=16.29; CI:2.75-96.42), non-white (OR=2.34; CI:1.00-5.50) hospitalized longer (4 to 7 days: OR=6.91; CI:2.40-19.96; more than 7 days: OR=3.03; CI:1.00-9.22), who scheduled to return to the hospital (OR=18.99; CI: 1.30-277.87), and that after discharge they needed help from someone to follow the medical recommendations (OR=3.16; CI:1.38-7.22). Conclusion: It was identified a high prevalence of multimorbidity, and important factors associated to multimorbidity in hospitalized elderly, with emphasis on education; color; hospitalization time; scheduling of return to hospital after discharge; need for help from someone (family member/caregiver), without post-discharge, to follow medical recommendations.
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Teixeira JJM, Bastos GCFC, Souza ACL. Perfil de internação de idosos. Rev Soc Bras Clin Med. 2017;15(1):15-20.
Amaral TLM, Amaral CA, Lima NS, Herculano PV, Prado PR, Monteiro GTR. Multimorbidade, depressão e qualidade de vida em idosos atendidos pela Estratégia de Saúde da Família em Senador Guiomard, Acre, Brasil. Cienc Saude Coletiva. 2018;23(9):3077-84. https://doi.org/10.1590/1413-81232018239.22532016
Ruiz M, Bottle A, Long S, Aylin P. Multi-morbidity in hospitalised older patients: who are the complex elderly?. PLoS One. 2015;10(12):e0145372. https://doi.org/10.1371/journal.pone.0145372
Kingston A, Robinson L, Booth H, Knapp M, Jagger C. Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model. Age Ageing. 2018;47(3):374-80. https://doi.org/10.1093/ageing/afx201
Carvalho JN, Roncalli AG, Cancela MC, Souza DLB. Prevalence of multimorbidity in the Brazilian adult population according to socioeconomic and demographic characteristics. PLoS One. 2017;12(4):e0174322. https://doi.org/10.1371/journal.pone.0174322
Nunes BP, Soares MU, Wachs LS, Volz PM, Saes MDO, Duro SMS, et al. Hospitalização em idosos: associação com multimorbidade, atenção básica e plano de saúde. Rev Saude Publica. 2017;51:43. https://doi.org/10.1590/S1518-8787.2017051006646
Pena MM, Melleiro MM. Grau de satisfação de usuários de um hospital privado. Acta Paul Enferm. 2012;25(2):197-200. https://doi.org/10.1590/S0103-21002012000200007
Schmidt SMS, Müller FM, Santos ED, Ceretta OS, Garlet V, Schmitt S. Análise da satisfação dos usuários em um hospital universitário. Saude Debate. 2014;38(101):305-17. https://doi.org/10.5935/0103-1104.20140028
Brasil. Ministério do planejamento, Orçamento e gestão. Instituto brasileiro de geografia e estatística. Pesquisa Nacional de saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. Brasília: Ministério da Saude, 2014.
Dantas CMHL, Bello FA, Barreto KL, Lima LS. Capacidade funcional de idosos com doenças crônicas residentes em Instituições de Longa Permanência. Rev Bras Enferm. 2013;66(6):914-20. https://doi.org/10.1590/S0034-71672013000600016
Melo LA, Braga LC, Leite FPP, Bittar BF, Oséas JMF, Lima KC. Fatores associados à multimorbidade em idosos: uma revisão integrativa da literatura. Rev Bras Geriatr Gerontol. 2019;22(1):e180154. https://doi.org/10.1590/1981-22562019022.180154
Nunes JD, Saes MDO, Nunes BP, Siqueira FCV, Soares DC, Fassa MEG, et al. Indicadores de incapacidade funcional e fatores associados em idosos: estudo de base populacional em Bagé, Rio Grande do Sul. Epidemiol Serv Saude. 2017;26(2):295-304. https://doi.org/10.5123/S1679-49742017000200007
Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity : A systematic review of the literature. Ageing Res Rev. 2011;10(4):430-9. https://doi.org/10.1016/j.arr.2011.03.003
Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies. J Comorb. 2019;9:1-15. https://doi.org/10.1177/2235042X19870934
Mini GK, Thankappan KR. Pattern, correlates and implications of non-communicable disease multimorbidity among older adults in selected Indian states: a cross-sectional study. BMJ Open. 2017;7(3):e013529. https://doi.org/10.1136/bmjopen-2016-013529
Forman DE, Maurer MS, Boyd C, Brindis R, Salive ME, Horne FM, et al. Multimorbidity in Older Adults With Cardiovascular Disease. J Am Coll Cardiol. 2018;71(19):2149-61. https://doi.org/10.1016/j.jacc.2018.03.022
Chung RY, Mercer SW, Yip BHK, Chan SWC, Lai FTT, Wang HHX, et al. The association between types of regular primary care and hospitalization among people with and without multimorbidity: A household survey on 25,780 Chinese. Sci Rep. 2016;6:29758. https://doi.org/10.1038/srep29758
Gruneir A, Bronskill SE, Maxwell CJ, Bai YQ, Kone AJ, Thavorn K, et al. The association between multimorbidity and hospitalization is modified by individual demographics and physician continuity of care: a retrospective cohort study. BMC Health Serv Res. 2016;16:154. https://doi.org/10.1186/s12913-016-1415-5
Williams J, Allen L, Wickramasinghe K, Mikkelsen B, Roberts N, Townsend N. A systematic review of associations between non-communicable diseases and socioeconomic status within low- and lower-middle-income countries. J Glob Health. 2018;8(2):020409. https://doi.org/10.7189/jogh.08.020409
Borde E, Hernández-Álvarez M, Porto MFS. Uma análise crítica da abordagem dos Determinantes Sociais da Saúde a partir da medicina social e saúde coletiva latino-americana. Saude Debate. 2015;39(106):841-54. https://doi.org/10.1590/0103-1104201510600030023
Güths JFS, Jacob MHVM, Santos AMPV, Arossi GA, Béria JU. Perfil sociodemográfico, aspectos familiares, percepção de saúde, capacidade funcional e depressão em idosos institucionalizados no Litoral Norte do Rio Grande do Sul. Rev Bras Geriatr Gerontol. 2017;20(2):175-85. https://doi.org/10.1590/1981-22562017020.160058
Nunes BP, Thumé E, Facchini LA. Multimorbidity in older adults: magnitude and challenges for the Brazilian health system. BMC Public Health. 2015;15(11):72. https://doi.org/10.1186/s12889-015-2505-8
Oliveira BLCA, Thomaz EBAF, Silva RA. The association between skin color/race and health indicators in elderly Brazilians: a study based on the Brazilian National Household Sample Survey (2008). Cad Saude Publica. 2014;30(7):1438-52. https://doi.org/10.1590/0102-311X00071413
Bordin D, Cabral LPA, Fadel CB, Santos CB, Grden CRB. Fatores associados à internação hospitalar de idosos: estudo de base Nacional. Rev Bras Geriatr Gerontol. 2018;21(4):452-60. https://doi.org/10.1590/1981-22562018021.180059
Chor D. Desigualdades em saúde no Brasil: é preciso ter raça. Cad Saude Publica. 2013;29(7):1272-5. https://doi.org/10.1590/S0102-311X2013000700002
Silva SPC, Menandro MCS. As representações sociais da saúde e de seus cuidados para homens e mulheres idosos. Saude Soc. 2014;23(2):626-40. https://doi.org/10.1590/S0104-12902014000200022
Sousa-Muñoz RL, Ronconi DE, Dantas GC, Lucena DMS, Silva IBA. Impacto de multimorbidade sobre mortalidade em idosos: estudo de coorte pós-hospitalização. Rev Bras Geriatr Gerontol. 2013;16(3):579-89. https://doi.org/10.1590/S1809-98232013000300015
Farmer C, Fenu E, O`Flynn N, Guthrie B. Clinical assessment and management of multimorbidity: summary of NICE guidance. BJM. 2016;354:i4843. https://doi.org/10.1136/bmj.i4843
Kernkamp CL, Costa CKF, Massuda EM, Silva ES, Yamaguchi MU, Bernuci MP. Perfil de morbidade e gastos hospitalares com idosos no Paraná, Brasil, entre 2008 e 2012. Cad Saude Publica. 2016;32(7):441-5. https://doi.org/10.1590/0102-311X00044115
Flesch LD, Araujo TCCF. Alta hospitalar de pacientes idosos: necessidades e desafios do cuidado contínuo. Estud Psicol. 2014;3(19):157-238. https://doi.org/10.1590/S1413-294X2014000300008
Wen Y, Chen L, Hsiao F. Predicting mortality and hospitalization o folder adults by the multimorbidity frailty index. PLoS One. 2017;12(11):e0187825. https://doi.org/10.1371/journal.pone.0187825
Wachs LS, Nunes BP, Soares UM, Facchini LA, Thumé E. Prevalência da assistência domiciliar prestada à população idosa brasileira e fatores associados. Cad Saude Publica. 2016;32(3):48-51. https://doi.org/10.1590/0102-311X00048515
Souza ICP, Silva AG, Quirino ACS, Neves MS, Moreira LR. Perfil de pacientes dependentes hospitalizados e cuidadores familiares: conhecimento e preparo para as práticas do cuidado domiciliar. Rev Min Enf. 2014;18(1):164-72. https://doi.org/10.5935/1415-2762.20140013
Almeida L, Azevedo RCS, Reiners AAO, Sudré MRS. Cuidado realizado pelo cuidador familiar ao idoso Dependente, em domicílio, no contexto da estratégia de Saúde da família. Texto Contexto Enferm. 2012;21(3):543-8. https://doi.org/10.1590/S0104-07072012000300008