Giovanni Corrao1,2, Federico Rea1,2, Flavia Carle1,3, Mirko Di Martino4, Rossana De Palma5, Paolo Francesconi6, Vito Lepore7, Luca Merlino1,8, Salvatore Scondotto9, Donatella Garau1,10, Liana Spazzafumo1,11, Giuseppe Montagano12, Elena Clagnan13, Nello Martini14. 1. Department of Statistics and Quantitative Methods, National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy. 2. Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy. 3. Center of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy. 4. Department of Epidemiology, Lazio Regional Health Service, Rome, Italy. 5. Authority for Healthcare and Welfare, Emilia Romagna Regional Health Service, Bologna, Italy. 6. Regional Health Agency of Tuscany (Agenzia regionale di sanità), Florence, Italy. 7. Regional Health Agency of Puglia (Agenzia regionale socio-sanitaria), Bari, Italy. 8. Epidemiologic Observatory, Lombardy Regional Health Service, Milan, Italy. 9. Epidemiologic Observatory, Sicily Regional Health Service, Palermo, Italy. 10. Regional Councillorship of Health 'Regione Autonoma della Sardegna', Cagliari, Italy. 11. Biostatistics Centre, INRCA-IRCCS National Institute, Ancona, Italy. 12. Basilicata Regional Health Service, Potenza, Italy. 13. Regional Health Agency of Friuli-Venezia-Giulia (Azienda Regionale di Coordinamento per la Salute), Udine, Italy. 14. Research and Health Foundation (Fondazione ReS-Ricerca e Salute), Bologna, Italy.
Abstract
BACKGROUND: Multimorbidity is a growing concern for healthcare systems, with many countries experiencing demographic transition to older population profiles. A simple multisource comorbidity score (MCS) has been recently developed and validated. A very large real-world investigation was conducted with the aim of measuring inequalities in the MCS distribution across Italy. METHODS: Beneficiaries of the Italian National Health Service aged 50-85 years who in 2018 were resident in one of the 10 participant regions formed the study population (15.7 million of the 24.9 million overall resident in Italy). MCS was assigned to each beneficiary by categorizing the individual sum of the comorbid values (i.e. the weights corresponding to the comorbid conditions of which the individual suffered) into one of the six categories denoting a progressive worsening comorbidity status. MCS distributions in women and men across geographic partitions were compared. RESULTS: Compared with beneficiaries from northern Italy, those from centre and south showed worse comorbidity profile for both women and men. MCS median age (i.e. the age above which half of the beneficiaries suffered at least one comorbidity) ranged from 60 (centre and south) to 68 years (north) in women and from 63 (centre and south) to 68 years (north) in men. The percentage of comorbid population was lower than 50% for northern population, whereas it was around 60% for central and southern ones. CONCLUSION: MCS allowed of capturing geographic variability of multimorbidity prevalence, thus showing up its value for addressing health policy in order to guide national health planning.
BACKGROUND: Multimorbidity is a growing concern for healthcare systems, with many countries experiencing demographic transition to older population profiles. A simple multisource comorbidity score (MCS) has been recently developed and validated. A very large real-world investigation was conducted with the aim of measuring inequalities in the MCS distribution across Italy. METHODS: Beneficiaries of the Italian National Health Service aged 50-85 years who in 2018 were resident in one of the 10 participant regions formed the study population (15.7 million of the 24.9 million overall resident in Italy). MCS was assigned to each beneficiary by categorizing the individual sum of the comorbid values (i.e. the weights corresponding to the comorbid conditions of which the individual suffered) into one of the six categories denoting a progressive worsening comorbidity status. MCS distributions in women and men across geographic partitions were compared. RESULTS: Compared with beneficiaries from northern Italy, those from centre and south showed worse comorbidity profile for both women and men. MCS median age (i.e. the age above which half of the beneficiaries suffered at least one comorbidity) ranged from 60 (centre and south) to 68 years (north) in women and from 63 (centre and south) to 68 years (north) in men. The percentage of comorbid population was lower than 50% for northern population, whereas it was around 60% for central and southern ones. CONCLUSION: MCS allowed of capturing geographic variability of multimorbidity prevalence, thus showing up its value for addressing health policy in order to guide national health planning.