Impact of Socioeconomic Inequalities in Transition Between Health, Multimorbidity and Death Amongst Older People
What is the Impact of Socioeconomic Inequalities in the Rates of Transition Between Health, Multimorbidity and Death Amongst Older People in England?
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
The association between social inequality and cause-specific mortality and single disease morbidity has been studied extensively. However, it remains unclear whether having two or more chronic diseases concurrently (or 'multimorbidity') plays a role in contributing to the inequalities gap in survival. This is particularly relevant given an ageing population and the trend of a widening in the life expectancy gap across several European countries.
Multimorbidity incidence increases rapidly with age. Estimates of the prevalence of multimorbidity in older people range from 55% to 98%, mainly due to the selection of diseases included, population coverage (hospital, community) and data source (self-reported surveys or clinical records). However, across all studies there is a clear and consistent pattern of higher prevalence rates at older ages, with multimorbidity.
Many aspects of the patient health trajectory remain under-explored. Patient case-mixes are likely to vary across socioeconomic groups, alongside a host of prognostic factors, including the clustering of multiple risk factors, age of onset, and disease presentation, progression and management in the presence of multiple health conditions.
Undersøgelsestype
Tilmelding (Forventet)
Kontakter og lokationer
Studiesteder
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London, Det Forenede Kongerige, WC1 E7H
- University College London
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- Registered with a participating practice that has agreed to data linkage
- Registered with an 'up to standard' participating general practice for at least 1 year
- Aged 45 and over on Jan 1st 2001 or who turn 45 between 1st Jan 2001 and 25th March 2010, irrespective of initial health status.
Exclusion Criteria:
- Patients with a record unlinked to deprivation due to missing or incomplete postcode of residence.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
|---|---|
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Healthy
Patients without any of the pre-specified chronic diseases
|
This study is based on the retrospective analysis of linked electronic health records.
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Multimorbid
Patients having any two or more of the pre-specified chronic diseases
|
This study is based on the retrospective analysis of linked electronic health records.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Yearly multimorbidity incidence rate
Tidsramme: 10 years
|
Numerator: Of patients with either 0 or 1 chronic diseases as on 1st Jan of the year, all those who become multimorbid by 31st Dec of the year. Denominator: patient years at risk of patients with either 0 or 1 chronic diseases as on 1st Jan of the year |
10 years
|
|
Yearly multimorbidity prevalence
Tidsramme: 10 years
|
Numerator: all those with 2 or more listed diseases on 1st July of the year.
Denominator: All eligible patients on 1st July of the year, irrespective of disease status on that date.
|
10 years
|
|
Yearly all-cause mortality rates
Tidsramme: 10 years
|
Numerator: number of deaths until 31st Dec of the year amongst the patients included in the denominator. Denominator: Person years at risk of patients with 0,1,2 or more diseases on 1st Jan of the year. |
10 years
|
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Overall life expectancy
Tidsramme: 10 years
|
Incident rates of transitions between no disease, 1 disease, 2+ diseases, and death.
|
10 years
|
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Health state-specific life expectancies
Tidsramme: 10 years
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Incident rates of transitions between four health states - no disease, 1 disease, 2+ diseases, and death.
|
10 years
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Yearly non-accidental mortality rates
Tidsramme: 10 years
|
As outcome 3 but excluding accidental deaths from the numerator
|
10 years
|
Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Studieleder: Madhavi Bajekal, PhD, University College, London
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Forventet)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
- 14_179
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