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?
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Inscription (Anticipé)
Contacts et emplacements
Lieux d'étude
-
-
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London, Royaume-Uni, WC1 E7H
- University College London
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
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.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
|
Healthy
Patients without any of the pre-specified chronic diseases
|
This study is based on the retrospective analysis of linked electronic health records.
|
|
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.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Yearly multimorbidity incidence rate
Délai: 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
Délai: 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
Délai: 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
|
|
Overall life expectancy
Délai: 10 years
|
Incident rates of transitions between no disease, 1 disease, 2+ diseases, and death.
|
10 years
|
|
Health state-specific life expectancies
Délai: 10 years
|
Incident rates of transitions between four health states - no disease, 1 disease, 2+ diseases, and death.
|
10 years
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Yearly non-accidental mortality rates
Délai: 10 years
|
As outcome 3 but excluding accidental deaths from the numerator
|
10 years
|
Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Directeur d'études: Madhavi Bajekal, PhD, University College, London
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
- 14_179
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