Multimorbidade em idosos brasileiros: prevalência, agrupamentos e redes de morbidades, continuidade de cuidado e utilização de serviços de saúde
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2019-08-22
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Universidade Federal de Goiás
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Multimorbity (MM), a simultaneous presence of two or more chronic diseases in the same individual, presents high prevalence and is related to important negative outcomes, especially in the elderly. Although frequent, the studies about MM are scarce. The aims of this study are to evaluate the presence of MM and associated factors, the presence of clusters/networking of morbidities and to analyze the potential effect of continuity of care in primary care (CCPC) in health services use among elderly people. Thus, we conducted the cross-sectional, population-based study using data from the National Health Survey (PNS-2013), with the analysis of 11,177 elderly people from all Brazilian states. MM was evaluated by the patient's self report, questionnaire for depression and anthropometric measurements, being categorized by three cut points: ≥2 physical and/or mental morbidities (MM2), ≥3 physical and/or mental morbidities (MM3) and ≥2 morbidities being at least one mental morbidity (MMpm). CCPC was analyzed by the presence of regular care source. The use of health services was analysed according to the demand for health services ≥15 days, medical consultation ≥12 months and hospitalization ≥1 year. Higher prevalence of MM was observed (MM2: 58.6%, MM3: 36.4%, MMpm: 12.2%). High blood pressure was the more frequent disease (50.6%), followed by back problems, high cholesterol and obesity. Hypertension/high cholesterol was teh par of higher occurrence (16.9%). In the adjusted analysis, being female and living in the South region was associated with all categories of MM. Independent of cutoff point, we observed elevated use of health services in the three categories analyzed. CCPC was present in 36.5%, being higher in women (37.78% vs. 34.95%). Less hospitalization was observed in people with MM2 and CCPC compared to those without CCPC, a fact also observed in MM3. Prevalence of MM in Brazilian series with high association with females and living in the South region. Our studies demonstrate that CCPC is an important component of care in elderly patients with multimorbity, aiming to reduce hospitalizations. Other studies are needed to clarify the different forms of CCPC that affect and strengthen services in health services. The Unified Health System should prioritize the care of the elderly with MM.
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BATISTA, S. R. R. Multimorbidade em idosos brasileiros: prevalência, agrupamentos e redes de morbidades, continuidade de cuidado e utilização de serviços de saúde. 2019. 147 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2019.