Skip to main content
Erschienen in: Quality of Life Research 4/2013

01.05.2013

Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey

verfasst von: Calypse B. Agborsangaya, Darren Lau, Markus Lahtinen, Tim Cooke, Jeffrey A. Johnson

Erschienen in: Quality of Life Research | Ausgabe 4/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We assessed the associations between multimorbidity and health-related quality of life (HRQL), and healthcare utilization, based on 16 common self-reported chronic conditions.

Methods

A cross-sectional questionnaire survey including the EQ-5D was conducted in a sample of the general population of adults (≥18 years) living in Alberta, Canada. Multiple linear and logistic regressions were used to assess the association between multiple chronic conditions and HRQL, hospitalization and emergency department (ED) use.

Results

A total of 4,946 respondents reported their HRQL, noting problems mostly with pain or discomfort (48.0 %). All chronic conditions were associated with a clinically important reduction in HRQL, the highest burden with anxiety or depression (−0.19, 95 % CI −0.21, −0.16) and chronic pain (−0.19, 95 % CI −0.21, −0.17). Multimorbidity was associated with a clinically important reduction in the EQ-5D index score (−0.12, 95 % CI −0.14, −0.11) and twice the likelihood of being hospitalized (OR = 2.2, 95 % CI 1.7, 2.9) or having an ED visit (OR = 1.8, 95 % CI 1.4, 2.2).

Conclusions

Pain or discomfort is a common problem in people living with chronic conditions, and the existence of multimorbidity in these individuals is associated with a reduction in the HRQL as well as frequent hospitalization and emergency department visits.
Literatur
1.
Zurück zum Zitat Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A. L., & Maltais, D. (2004). Multimorbidity and quality of life in primary care: A systematic review. Health Quality Life Outcomes, 2, 51.CrossRef Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A. L., & Maltais, D. (2004). Multimorbidity and quality of life in primary care: A systematic review. Health Quality Life Outcomes, 2, 51.CrossRef
2.
Zurück zum Zitat Condelius, A., Edberg, A. K., Jakobsson, U., & Hallberg, I. R. (2008). Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Archives of Gerontology and Geriatrics, 46(1), 6.CrossRef Condelius, A., Edberg, A. K., Jakobsson, U., & Hallberg, I. R. (2008). Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Archives of Gerontology and Geriatrics, 46(1), 6.CrossRef
3.
Zurück zum Zitat Librero, J., Peiro, S., & Ordinana, R. (1999). Chronic comorbidity and outcomes of hospital care: Length of stay, mortality, and readmission at 30 and 365 days. Journal of Clinical Epidemiology, 52(3), 171–179.PubMedCrossRef Librero, J., Peiro, S., & Ordinana, R. (1999). Chronic comorbidity and outcomes of hospital care: Length of stay, mortality, and readmission at 30 and 365 days. Journal of Clinical Epidemiology, 52(3), 171–179.PubMedCrossRef
4.
Zurück zum Zitat Taylor, A. W., Price, K., Gill, T. K., Adams, R., Pilkington, R., Carrangis, N., et al. (2010). Multimorbidity—Not just an older person’s issue. Results from an Australian biomedical study. BMC Public Health, 10, 718.PubMedCrossRef Taylor, A. W., Price, K., Gill, T. K., Adams, R., Pilkington, R., Carrangis, N., et al. (2010). Multimorbidity—Not just an older person’s issue. Results from an Australian biomedical study. BMC Public Health, 10, 718.PubMedCrossRef
5.
Zurück zum Zitat Marengoni, A., Rizzuto, D., Wang, H. X., Winblad, B., & Fratiglioni, L. (2009). Patterns of chronic multimorbidity in the elderly population. Journal of the American Geriatrics Society, 57(2), 225–230.PubMedCrossRef Marengoni, A., Rizzuto, D., Wang, H. X., Winblad, B., & Fratiglioni, L. (2009). Patterns of chronic multimorbidity in the elderly population. Journal of the American Geriatrics Society, 57(2), 225–230.PubMedCrossRef
6.
Zurück zum Zitat Schafer, I., von Leitner, E. C., Schon, G., Koller, D., Hansen, H., Kolonko, T., et al. (2010). Multimorbidity patterns in the elderly: A new approach of disease clustering identifies complex interrelations between chronic conditions. PLoS ONE, 5(12), e15941.PubMedCrossRef Schafer, I., von Leitner, E. C., Schon, G., Koller, D., Hansen, H., Kolonko, T., et al. (2010). Multimorbidity patterns in the elderly: A new approach of disease clustering identifies complex interrelations between chronic conditions. PLoS ONE, 5(12), e15941.PubMedCrossRef
7.
Zurück zum Zitat Hodek, J. M., Ruhe, A., & Greiner, W. (2009). Multimorbidity and health-related quality of life among elderly persons]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 52(12), 1188–1201.PubMedCrossRef Hodek, J. M., Ruhe, A., & Greiner, W. (2009). Multimorbidity and health-related quality of life among elderly persons]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 52(12), 1188–1201.PubMedCrossRef
8.
Zurück zum Zitat The World Health Organization Quality of Life Assessment (WHOQOL). (1998). Development and general psychometric properties. Social Science & Medicine, 46(12), 1569–1585. The World Health Organization Quality of Life Assessment (WHOQOL). (1998). Development and general psychometric properties. Social Science & Medicine, 46(12), 1569–1585.
9.
Zurück zum Zitat Galenkamp, H., Braam, A. W., Huisman, M., & Deeg, D. J. H. (2011). Somatic multimorbidity and self-rated health in the older population. Series B, Psychological Sciences and Social Sciences. Journals of Gerontology, 66(3), 380–386.PubMedCrossRef Galenkamp, H., Braam, A. W., Huisman, M., & Deeg, D. J. H. (2011). Somatic multimorbidity and self-rated health in the older population. Series B, Psychological Sciences and Social Sciences. Journals of Gerontology, 66(3), 380–386.PubMedCrossRef
10.
Zurück zum Zitat Wang, H.-M., Beyer, M., Gensichen, J., & Gerlach, F. M. (2008). Health-related quality of life among general practice patients with differing chronic diseases in Germany: Cross sectional survey. BMC Public Health, 8, 246. Wang, H.-M., Beyer, M., Gensichen, J., & Gerlach, F. M. (2008). Health-related quality of life among general practice patients with differing chronic diseases in Germany: Cross sectional survey. BMC Public Health, 8, 246.
11.
Zurück zum Zitat Fortin, M., Bravo, G., Hudon, C., Lapointe, L., Almirall, J., Dubois, M.-F., et al. (2006). Relationship between multimorbidity and health-related quality of life of patients in primary care. Quality of Life Research, 15(1), 83–91.PubMedCrossRef Fortin, M., Bravo, G., Hudon, C., Lapointe, L., Almirall, J., Dubois, M.-F., et al. (2006). Relationship between multimorbidity and health-related quality of life of patients in primary care. Quality of Life Research, 15(1), 83–91.PubMedCrossRef
12.
Zurück zum Zitat Cheng, L., Cumber, S., Dumas, C., Winter, R., Nguyen, K. M., & Nieman, L. Z. (2003). Health related quality of life in pregeriatric patients with chronic diseases at urban, public supported clinics. Health Quality of Life Outcomes, 1, 63.CrossRef Cheng, L., Cumber, S., Dumas, C., Winter, R., Nguyen, K. M., & Nieman, L. Z. (2003). Health related quality of life in pregeriatric patients with chronic diseases at urban, public supported clinics. Health Quality of Life Outcomes, 1, 63.CrossRef
13.
Zurück zum Zitat Revicki, D. A. (1989). Health-related quality of life in the evaluation of medical therapy for chronic illness. The Journal of family practice, 29(4), 377–380.PubMed Revicki, D. A. (1989). Health-related quality of life in the evaluation of medical therapy for chronic illness. The Journal of family practice, 29(4), 377–380.PubMed
14.
Zurück zum Zitat Greiner, W., Weijnen, T., Nieuwenhuizen, M., Oppe, S., Badia, X., Busschbach, J., et al. (2003). A single European currency for EQ-5D health states. Results from a six-country study. European Journal of Health Economics, 4(3), 222–231.PubMedCrossRef Greiner, W., Weijnen, T., Nieuwenhuizen, M., Oppe, S., Badia, X., Busschbach, J., et al. (2003). A single European currency for EQ-5D health states. Results from a six-country study. European Journal of Health Economics, 4(3), 222–231.PubMedCrossRef
15.
Zurück zum Zitat Maddigan, S. L., Feeny, D. H., & Johnson, J. A. (2005). Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey. Quality of Life Research, 14(5), 1311–1320.PubMedCrossRef Maddigan, S. L., Feeny, D. H., & Johnson, J. A. (2005). Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey. Quality of Life Research, 14(5), 1311–1320.PubMedCrossRef
16.
Zurück zum Zitat Bowker, S. L., Pohar, S. L., & Johnson, J. A. (2006). A cross-sectional study of health-related quality of life deficits in individuals with comorbid diabetes and cancer. Health Quality of Life Outcomes, 4, 17.CrossRef Bowker, S. L., Pohar, S. L., & Johnson, J. A. (2006). A cross-sectional study of health-related quality of life deficits in individuals with comorbid diabetes and cancer. Health Quality of Life Outcomes, 4, 17.CrossRef
17.
Zurück zum Zitat van Nispen, R. M., de Boer, M. R., Hoeijmakers, J. G., Ringens, P. J., & van Rens, G. H. (2009). Co-morbidity and visual acuity are risk factors for health-related quality of life decline: Five-month follow-up EQ-5D data of visually impaired older patients. Health Quality of Life Outcomes, 7, 18.CrossRef van Nispen, R. M., de Boer, M. R., Hoeijmakers, J. G., Ringens, P. J., & van Rens, G. H. (2009). Co-morbidity and visual acuity are risk factors for health-related quality of life decline: Five-month follow-up EQ-5D data of visually impaired older patients. Health Quality of Life Outcomes, 7, 18.CrossRef
18.
Zurück zum Zitat Perkins, H. Y., Baum, G. P., Taylor, C. L., & Basen-Engquist, K. M. (2009). Effects of treatment factors, comorbidities and health-related quality of life on self-efficacy for physical activity in cancer survivors. Psychooncology, 18(4), 405–411.PubMedCrossRef Perkins, H. Y., Baum, G. P., Taylor, C. L., & Basen-Engquist, K. M. (2009). Effects of treatment factors, comorbidities and health-related quality of life on self-efficacy for physical activity in cancer survivors. Psychooncology, 18(4), 405–411.PubMedCrossRef
19.
Zurück zum Zitat Hunger, M., Thorand, B., Schunk, M., Doring, A., Menn, P., Peters, A., et al. (2011). Multimorbidity and health-related quality of life in the older population: Results from the German KORA-Age study. Health Quality of Life Outcomes, 18, 9–53. Hunger, M., Thorand, B., Schunk, M., Doring, A., Menn, P., Peters, A., et al. (2011). Multimorbidity and health-related quality of life in the older population: Results from the German KORA-Age study. Health Quality of Life Outcomes, 18, 9–53.
20.
Zurück zum Zitat HQCA. (2010). Satisfaction and experience with health care services: A survey of Albertans (Technical Report 2010). Calgary: Health Quality Council of Alberta. HQCA. (2010). Satisfaction and experience with health care services: A survey of Albertans (Technical Report 2010). Calgary: Health Quality Council of Alberta.
21.
Zurück zum Zitat Johnson, J. A., & Pickard, A. S. (2000). Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Medical Care, 38(1), 115–118.PubMedCrossRef Johnson, J. A., & Pickard, A. S. (2000). Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Medical Care, 38(1), 115–118.PubMedCrossRef
22.
Zurück zum Zitat Shaw, J. W., Johnson, J. A., & Coons, S. J. (2005). US valuation of the EQ-5D health states: Development and testing of the D1 valuation model. Medical Care, 43(3), 203–220.PubMedCrossRef Shaw, J. W., Johnson, J. A., & Coons, S. J. (2005). US valuation of the EQ-5D health states: Development and testing of the D1 valuation model. Medical Care, 43(3), 203–220.PubMedCrossRef
23.
Zurück zum Zitat Kaplan, R. M. (2005). The minimally clinically important difference in generic utility-based measures. COPD, 2(1), 91–97.PubMedCrossRef Kaplan, R. M. (2005). The minimally clinically important difference in generic utility-based measures. COPD, 2(1), 91–97.PubMedCrossRef
24.
Zurück zum Zitat Rothman, K. J. (1990). No adjustments are needed for multiple comparisons. Epidemiology, 1(1), 43–46.PubMedCrossRef Rothman, K. J. (1990). No adjustments are needed for multiple comparisons. Epidemiology, 1(1), 43–46.PubMedCrossRef
25.
Zurück zum Zitat Cuijpers, P., van Lammeren, P., & Duzijn, B. (1999). Relation between quality of life and chronic illnesses in elderly living in residential homes: A prospective study. International Psychogeriatrics, 11(4), 445–454.PubMedCrossRef Cuijpers, P., van Lammeren, P., & Duzijn, B. (1999). Relation between quality of life and chronic illnesses in elderly living in residential homes: A prospective study. International Psychogeriatrics, 11(4), 445–454.PubMedCrossRef
26.
Zurück zum Zitat Allison, P. J., Locker, D., & Feine, J. S. (1997). Quality of life: A dynamic construct. Social Science and Medicine, 45(2), 221–230.PubMedCrossRef Allison, P. J., Locker, D., & Feine, J. S. (1997). Quality of life: A dynamic construct. Social Science and Medicine, 45(2), 221–230.PubMedCrossRef
27.
Zurück zum Zitat Sprangers, M. A., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science and Medicine, 48(11), 1507–1515.PubMedCrossRef Sprangers, M. A., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science and Medicine, 48(11), 1507–1515.PubMedCrossRef
28.
Zurück zum Zitat Howard, J. S., Mattacola, C. G., Howell, D. M., & Lattermann, C. (2011). Response shift theory: An application for health-related quality of life in rehabilitation research and practice. Journal of Allied Health, 40(1), 31–38.PubMed Howard, J. S., Mattacola, C. G., Howell, D. M., & Lattermann, C. (2011). Response shift theory: An application for health-related quality of life in rehabilitation research and practice. Journal of Allied Health, 40(1), 31–38.PubMed
29.
Zurück zum Zitat Kohen, D., Burgess, A. P., Catalan, J., & Lant, A. (1998). The role of anxiety and depression in quality of life and symptom reporting in people with diabetes mellitus. Quality of Life Research, 7(3), 197–204.PubMedCrossRef Kohen, D., Burgess, A. P., Catalan, J., & Lant, A. (1998). The role of anxiety and depression in quality of life and symptom reporting in people with diabetes mellitus. Quality of Life Research, 7(3), 197–204.PubMedCrossRef
30.
Zurück zum Zitat Eren, I., Erdi, O., & Sahin, M. (2008). The effect of depression on quality of life of patients with type II diabetes mellitus. Depress Anxiety, 25(2), 98–106.PubMedCrossRef Eren, I., Erdi, O., & Sahin, M. (2008). The effect of depression on quality of life of patients with type II diabetes mellitus. Depress Anxiety, 25(2), 98–106.PubMedCrossRef
31.
Zurück zum Zitat Aarts, S., van den Akker, M., Hajema, K. J., van Ingen, A. M., Metsemakers, J. F., Verhey, F. R., et al. (2011). Multimorbidity and its relation to subjective memory complaints in a large general population of older adults. International Psychogeriatrics, 23(4), 616–624.PubMedCrossRef Aarts, S., van den Akker, M., Hajema, K. J., van Ingen, A. M., Metsemakers, J. F., Verhey, F. R., et al. (2011). Multimorbidity and its relation to subjective memory complaints in a large general population of older adults. International Psychogeriatrics, 23(4), 616–624.PubMedCrossRef
32.
Zurück zum Zitat Kontaxakis, V. P., Havaki-Kontaxaki, B. J., Stamouli, S. S., Margariti, M. M., Collias, C. T., & Christodoulou, G. N. (2000). Comparison of four scales measuring depression in schizophrenic inpatients. European Psychiatry, 15(4), 274–277.PubMedCrossRef Kontaxakis, V. P., Havaki-Kontaxaki, B. J., Stamouli, S. S., Margariti, M. M., Collias, C. T., & Christodoulou, G. N. (2000). Comparison of four scales measuring depression in schizophrenic inpatients. European Psychiatry, 15(4), 274–277.PubMedCrossRef
33.
Zurück zum Zitat Wolff, J. L., Starfield, B., & Anderson, G. (2002). Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Archives of Internal Medicine, 162(20), 2269–2276.PubMedCrossRef Wolff, J. L., Starfield, B., & Anderson, G. (2002). Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Archives of Internal Medicine, 162(20), 2269–2276.PubMedCrossRef
34.
Zurück zum Zitat Condelius, A., Edberg, A. K., Jakobsson, U., & Hallberg, I. R. (2008). Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Archives of Gerontology and Geriatrics, 46(1), 41–55.PubMedCrossRef Condelius, A., Edberg, A. K., Jakobsson, U., & Hallberg, I. R. (2008). Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Archives of Gerontology and Geriatrics, 46(1), 41–55.PubMedCrossRef
35.
Zurück zum Zitat Forrest, C. B., Nutting, P. A., von Schrader, S., Rohde, C., & Starfield, B. (2006). Primary care physician specialty referral decision making: patient, physician, and health care system determinants. Medical Decision Making, 26(1), 76–85.PubMedCrossRef Forrest, C. B., Nutting, P. A., von Schrader, S., Rohde, C., & Starfield, B. (2006). Primary care physician specialty referral decision making: patient, physician, and health care system determinants. Medical Decision Making, 26(1), 76–85.PubMedCrossRef
36.
Zurück zum Zitat Michelson, H., Bolund, C., & Brandberg, Y. (2000). Multiple chronic health problems are negatively associated with health related quality of life (HRQoL) irrespective of age. Quality of Life Research, 9(10), 1093–1104.PubMedCrossRef Michelson, H., Bolund, C., & Brandberg, Y. (2000). Multiple chronic health problems are negatively associated with health related quality of life (HRQoL) irrespective of age. Quality of Life Research, 9(10), 1093–1104.PubMedCrossRef
37.
Zurück zum Zitat Wensing, M., Vingerhoets, E., & Grol, R. (2001). Functional status, health problems, age and comorbidity in primary care patients. Quality of Life Research, 10(2), 141–148.PubMedCrossRef Wensing, M., Vingerhoets, E., & Grol, R. (2001). Functional status, health problems, age and comorbidity in primary care patients. Quality of Life Research, 10(2), 141–148.PubMedCrossRef
Metadaten
Titel
Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey
verfasst von
Calypse B. Agborsangaya
Darren Lau
Markus Lahtinen
Tim Cooke
Jeffrey A. Johnson
Publikationsdatum
01.05.2013
Verlag
Springer Netherlands
Erschienen in
Quality of Life Research / Ausgabe 4/2013
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-012-0214-7

Weitere Artikel der Ausgabe 4/2013

Quality of Life Research 4/2013 Zur Ausgabe