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?
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Verwacht)
Contacten en locaties
Studie Locaties
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London, Verenigd Koninkrijk, WC1 E7H
- University College London
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
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Healthy
Patients without any of the pre-specified chronic diseases
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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
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This study is based on the retrospective analysis of linked electronic health records.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Yearly multimorbidity incidence rate
Tijdsspanne: 10 years
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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
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Yearly multimorbidity prevalence
Tijdsspanne: 10 years
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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.
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10 years
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Yearly all-cause mortality rates
Tijdsspanne: 10 years
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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
Tijdsspanne: 10 years
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Incident rates of transitions between no disease, 1 disease, 2+ diseases, and death.
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10 years
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Health state-specific life expectancies
Tijdsspanne: 10 years
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Incident rates of transitions between four health states - no disease, 1 disease, 2+ diseases, and death.
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10 years
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Yearly non-accidental mortality rates
Tijdsspanne: 10 years
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As outcome 3 but excluding accidental deaths from the numerator
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10 years
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Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Studie directeur: Madhavi Bajekal, PhD, University College, London
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Verwacht)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Andere studie-ID-nummers
- 14_179
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