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Revista Clínica de Medicina de Familia
versão On-line ISSN 2386-8201versão impressa ISSN 1699-695X
Resumo
FERNANDEZ-BOSCH, Alba et al. Influence of multipathology and comorbidity on hospital admission in a cohort of patients from a Primary-Internal continuous care unit. Rev Clin Med Fam [online]. 2022, vol.15, n.2, pp.99-105. Epub 19-Set-2022. ISSN 2386-8201.
Objective:
to estimate the frequency of multiple pathologies and comorbidity in patients followed up in a Primary-Internal care continuity unit (PICCU), and to ascertain their clinical characteristics and degree of association between multiple pathologies and comorbidity with hospital admission.
Design:
retrospective case-control observational study.
Site:
Primary Care and Internal Medicine Continuity of Care Unit (UCAPI) of Albacete Teaching Hospital.
Participants:
a total of 1591 patients treated in a PICCU (292 with a hospital admission in the last year and 1299 without admission) were analyzed.
Main measurements:
age, sex, health problems, Charlson index, drug use and use of health services in the previous three years.
Results:
of the total sample, 18.4% (95% CI: 16.4-20.3) were cases with an admission; 23.3% had multiple pathologies (95% CI: 21.1-25.4) and comorbidity (Charlson index ≥ 2) 32.6% (95% CI: 30.2-34.9). Variables independently associated with hospital admission were multiple pathologies (OR: 2.51; 95% CI: 1.64-3.83; P <0.001), comorbidity (Charlson ≥ 2) (OR: 1.81; 95% CI): 1.18-2.78; P = 0.006), more than three health problems (OR: 1.49; 95% CI: 1.07-2.07; P = 0.017), a higher number of primary care consultations (OR: 1.01; 95% CI: 1.00-1.02; P = 0.005), Hospital (1.03; 95% CI: 1.01-1.05), P < 0.001) and making more visits to the hospital accident and emergency department (OR: 1.12, 95% CI: 1.07-1.17).
Conclusions:
almost a quarter of patients followed up in a care continuity unit between internal and family medicine presented multiple pathologies and a third presented comorbidity. Multiple pathologies and comorbidity are predictive characteristics of hospital admission together with a greater use of health services.
Palavras-chave : comorbidity; health services; hospitalization; multimorbidity.