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#multimorbidity

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Public
Matteo Cesari :stethoscope:

#Multimorbidity and adverse outcomes following #emergency department attendance: population-based cohort study

"...The increasing prevalence of multimorbidity in the population is likely to exacerbate strain on emergency departments unless practice and #policy evolve to meet the growing demand..."

#Ageing #Aging #Care #Health #Geriatrics #Frailty

bmjmedicine.bmj.com/content/3/

BMJ Medicine · Multimorbidity and adverse outcomes following emergency department attendance: population based cohort studyObjectives To describe the effect of multimorbidity on adverse patient centred outcomes in people attending emergency department. Design Population based cohort study. Setting Emergency departments in NHS Lothian in Scotland, from 1 January 2012 to 31 December 2019. Participants Adults (≥18 years) attending emergency departments. Data sources Linked data from emergency departments, hospital discharges, and cancer registries, and national mortality data. Main outcome measures Multimorbidity was defined as at least two conditions from the Elixhauser comorbidity index. Multivariable logistic or linear regression was used to assess associations of multimorbidity with 30 day mortality (primary outcome), hospital admission, reattendance at the emergency department within seven days, and time spent in emergency department (secondary outcomes). Primary analysis was stratified by age (<65  v ≥65 years). Results 451 291 people had 1 273 937 attendances to emergency departments during the study period. 43 504 (9.6%) had multimorbidity, and people with multimorbidity were older (median 73 v 43 years), more likely to arrive by emergency ambulance (57.8% v 23.7%), and more likely to be triaged as very urgent (23.5% v 9.2%) than people who do not have multimorbidity. After adjusting for other prognostic covariates, multimorbidity, compared with no multimorbidity, was associated with higher 30 day mortality (8.2% v 1.2%, adjusted odds ratio 1.81 (95% confidence interval (CI) 1.72 to 1.91)), higher rate of hospital admission (60.1% v 20.5%, 1.81 (1.76 to 1.86)), higher reattendance to an emergency department within seven days (7.8% v 3.5%, 1.41 (1.32 to 1.50)), and longer time spent in the department (adjusted coefficient 0.27 h (95% CI 0.26 to 0.27)). The size of associations between multimorbidity and all outcomes were larger in younger patients: for example, the adjusted odds ratio of 30 day mortality was 3.03 (95% CI 2.68 to 3.42) in people younger than 65 years versus 1.61 (95% CI 1.53 to 1.71) in those 65 years or older. Conclusions Almost one in ten patients presenting to emergency department had multimorbidity using Elixhauser index conditions. Multimorbidity was strongly associated with adverse outcomes and these associations were stronger in younger people. The increasing prevalence of multimorbidity in the population is likely to exacerbate strain on emergency departments unless practice and policy evolve to meet the growing demand. No data are available.
Public
Matteo Cesari :stethoscope:

Population-Based Trends in Complexity of #Hospital Inpatients

"...Measures of patient #complexity that increased over a 15-year interval included the presence of advanced age, #multimorbidity, #polypharmacy, recent hospitalization, admission via the #emergency department, multiple acute medical problems, more than one adverse event, and prolonged hospital length of stay..."

#Geriatrics #Frailty #Aging #PublicHealth #Care #Health

jamanetwork.com/journals/jamai

jamanetwork.comPopulation-Based Trends in Complexity of Hospital InpatientsThis cohort study assesses whether there has been an increase in measures of hospital inpatient complexity in British Columbia, Canada, over a 15-year period.
Public
Matteo Cesari :stethoscope:

One Size Fits All—An Underappreciated #Health Inequity

"...this #disease-specific evidence is extrapolated from studies in which #women; older adults; #Black, #Hispanic, and other racially minoritized individuals; and persons with #multimorbidity or disabilities are largely underrepresented..."

jamanetwork.com/journals/jamai

jamanetwork.comUnderappreciated One-Size-FIts-All Health InequityThis Viewpoint discusses why health priorities–tailored care, rather than the one-size-fits-all approach, is beneficial for marginalized individuals.
Public
Matteo Cesari :stethoscope:

The Paradoxical Decline of Geriatric Medicine as a Profession

"...Our #health system and its workforce are wholly unprepared to deal with an imminent surge of #multimorbidity, functional impairment, #dementia, and #frailty. This is the reality that #healthcare organizations and medical schools have not adequately appreciated or have chosen to ignore..."

#Geriatrics #Care #Medicine

jamanetwork.com/journals/jama/

jamanetwork.comThe Paradoxical Decline of Geriatric Medicine as a ProfessionIn this Viewpoint, author Jerry Gurwitz discusses the attrition of geriatric medicine as a profession, attributing it in part to societal attitudes about aging and compounded by the negative effects of lower compensation and lack of career prestige.
Public
Jan R. Boehnke

#Introduction

Hi Mastodon!

I work at the School of Health Sciences, University of Dundee.

I research #MentalHealth MentalIllness #Multimorbidity.

I am interested in Health-related Quality of Life #HRQL
#HealthEconomics.

I have experience in the assessment & evaluation of research, thanks #REF2021 😂

I am a #NightshiftEditor & post about editing, publishing & #PeerReview.

Looking forward to exchanges about all these & will post the odd picture of my Scottish Environs.

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