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1.
Background
A longer time in consultation with doctors in ambulatory care has been associated with better quality of care. Patient experience is of great concern to policy makers and is linked with health-care quality. However, the relationship between consultation length and patient experience remains unclear. We aimed to investigate the effect of consultation length on patient experience, based on analysis of a cross-sectional nationwide patient survey data in China.Methods
We obtained patient survey data from a strati?ed nationwide survey sample that covered 136 tertiary hospitals in China. Patient-estimated consultation length and associated patient experience data were collected by questionnaire after each patient attended a face-to-face consultation with a doctor. The consultation experience was rated on a 5-point scale. We applied a two-piecewise linear regression model to examine the saturation effect of the consultation length on patient experience (consultation score), using a smoothing function, while age, sex, education, and profession were adjusted in the model, then estimated the turning point that gave the maximum model likelihood by using trial and error.Findings
Between Dec 18, 2017, and Dec 30, 2017, 27?721 patients, aged 15–85 years, were eligible and selected for inclusion. The median patient-reported duration of face-to-face ambulatory care consultation was 10 min (IQR 5–12), and the mean score of the consultation experience rated by the patient was 4·25 (SD 0·83; 95% CI 4·24–4·26) on the 5-point scale. After adjusting for potential confounders including age, sex, education, and profession, there was a non-linear relationship between consultation length and measure of patient experience after smooth curve fitting. A turning point at 8 min was identified in the modelling process. Below this point, there was a higher probability of rating a consultation score above average with longer consultation length (odds ratio [OR] 1·28, 95% CI 1·26–1·30, p<0·001). After this point, the OR changed to 1·03 (95% CI 1·02–1·04, p<0·001). There was a significant difference in patient experience measure before and after this consultation length turning point (p<0·001).Interpretation
Consultation length was associated with a measure of patient experience in a non-linear pattern. Longer consultations might not be required to achieve better patient experience, but an adequate consultation should not be shorter than 8 min. Future research about the appropriateness of consultation length for varies ambulatory care institutions would be of benefit.Funding
National Natural Science Foundation of China (71532014), National Health Commission of China 相似文献2.
Feng Jiang Huixuan Zhou Linlin Hu Tingfang Liu Shichao Wu Pengyu Zhao Guangyu Hu Huanzhong Liu Yilang Tang Yuanli Liu 《Lancet》2018
Background
China's Mental Health Law was implemented in 2013 to provide a legal foundation to protect patients' rights and provide involuntary treatment for patients at high risk of suicide or self-injury, or of harming others, or both. However, the law has not been thoroughly examined since its implementation. This study aimed to examine compliance of major psychiatric hospitals in China with the criteria of involuntary admission defined in the Mental Health Law.Methods
As part of a national survey, we collected data from discharged inpatients from 32 tertiary psychiatric hospitals across all 31 provinces of China. We manually retrieved patients' admission information from discharge medical records, and calculated the proportion of the patients who met the criteria of involuntary admission.Findings
We included data from 1663 (93%) of 1780 discharged inpatients from all hospitals. 814 (49%) of 1663 patients were admitted to hospital involuntarily. 369 (45%) of these 814 patients were admitted because of risks of suicide or self-injury, or of harming others, or both, as defined in the Mental Health Law. Among the 369 patients, 85 (23%) had risk of suicide or self-injury, 310 (84%) had risk of harming others, and 26 (7%) had both. The rest of the patients who were admitted involuntarily, although needing treatment, did not meet the Mental Health Law-defined criteria for involuntary admission.Interpretation
The number of involuntary admissions in major psychiatric hospitals in China is high. Fewer than half of the patients who were admitted involuntarily met the criteria for involuntary admission, as defined by the Mental Health Law. Psychiatric hospitals and clinicians need to be mindful of balancing the safety of patients or others and avoiding the unnecessary restriction of patients' freedom.Funding
Beijing Medical and Health Foundation. 相似文献3.
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5.
Shang-Ying Hu Rezhake Remila Qian Zhang Li Dong Li Zhang Rui-Mei Feng Xue-Lian Zhao Feng Chen Xun Zhang Qin-Jing Pan Wen-Hua Zhang Jun-Fei Ma You-Lin Qiao Fang-Hui Zhao 《Lancet》2017
Background
The long-term risk of progression or regression in women with biopsy-confirmed normal cervical epithelium or cervical intraepithelial neoplasia grade 1 (CIN1) is unclear. The aim of the study was to assess the rates of progression and regression of women with histological CIN1 or normal cervical epithelium in rural China.Methods
A screening cohort for cervical cancer was built in 1999 in Xiangyuan County, Shanxi Province, with a sample size of 1997 women aged 35–45 years, who were followed up in 2005 (6-year follow-up), 2010 (11-year follow-up), and 2014 (15-year follow-up) with human papillomavirus (HPV) DNA testing, liquid-based cytology, and visual inspection with acetic acid (except in 2014). Progression and regression rates of histological normal and CIN1 at different follow-up timepoints were calculated stratified by baseline HPV status.Findings
The cumulative rate of progression to CIN2+ among women who were CIN1 baseline was 7% (8/107) at 6-year follow-up, 21% (22/103) at 11-year follow-up, and 24% (23/96) at 15-year follow-up. Women who were CIN1 and HPV-positive had significantly higher progression rates (13% [8/63] at 6 years, 33% [20/60] at 11 years, and 36% [21/59] at 15 years) than did those who were CIN1 but were negative for HPV (0% [0/44], 5% [2/43], and 5% [2/37], respectively; p=0·014 at 6 years, p=0·0005 at 11 years, and p=0·0007 at 15 years). Meanwhile, up to 95% of women who were CIN1 and HPV negative at baseline regressed to normal during the 15-year period. Furthermore, the rates of progression to CIN2+ among women who were histologically normal was 1% (11/1543) at 6-year follow-up, 3% (40/1358) at 11-year follow-up, and 5% (60/1162) at 15-year follow-up; more than 90% of women maintained at normal during the 15-year period.Interpretation
HPV testing could be helpful to monitor women with CIN1 or normal cervical epithelium. The screening interval for those without HPV infection could be safely extended to 5–10 years, but those who are HPV-positive should be followed closely.Funding
National Natural Science Foundation of China (grant number 81050018, 81322040, 81402748); Chinese Academy of Medical Science Initiative for Innovative Medicine (2016-I2M-1-019). 相似文献6.
Yifan Diao Jie Qian Yang Liu Yanping Zhou Yan Wang Hong Ma Xiaoyan Wang Ren Luo Anita Wagner Jing Sun 《Lancet》2018
Background
Little evidence is available to demonstrate the effect of the emerging government insurance coverage on use and affordability of expensive anti-cancer medicines as well as insurance sustainability for patients in China. This study examined the insurance programme in Hangzhou, the capital city of Zhejiang province, as an example, focusing on the six targeted anti-cancer medicines that were newly covered by government insurance in January, 2015, and looked at how such inclusions influenced the use and affordability of these medicines.Methods
We used longitudinal hospital medicines procurement data collected by IQVIA (IMS Health and Quintiles) Institutes for health-care informatics to assess trajectories in use of medicines in 69 hospitals with more than 100 beds from January, 2013, to December, 2016. We conducted segmented regression analyses of interrupted time series data to measure changes in use of medicines over time. WHO/Health Action International Project on Medicine Prices and Availability methodology was used to measure the affordability of medicines. Key informant interviews were done to document the pharmaceutical company patient assistance programme and insurance policies.Findings
In March, 2015, the use of all studied medicines increased by 15·58 (95% CI 3·86–27·30, p=0·01, for imatinib) to 439·14 standard units (311·79–566·49, p<0·001, for cetuximab) in 1 month. Before introduction of insurance coverage, patients had to pay out-of-pocket 3·0–13·1 and 6·2–27·3 times the provincial average disposable annual income per capita in urban and rural areas, respectively; 1·5–6·4 and 3·1–13·4 times for those who were entitled tothe patient assistance programme. After introduction of insurance coverage in January, 2015, out-of-pocket payments were reduced to 0·6–2·1 and 1·8–4·4 times the provincial average disposable annual income per capita in urban and rural areas, respectively. By the end of 2016, cumulative total insurance expenses for the six targeted anti-cancer medicines accounted for 46% of the total amount of government catastrophic health funds collected for Hangzhou, which would reach 69% if the reimbursement rate was increased from 60% to 90%.Interpretation
Our findings suggest that government insurance coverage has a substantial role in increasing patients' access to expensive targeted anti-cancer medicines, with reduced individual financial burden, but it is still high, especially for low-income population. The sustainability of such systems requires close monitoring and appropriate use of medicines. Findings of this study provide directions for policy formation and financial risk management in relation to the government insurance.Funding
Peking Union Medical College Educational Fund. 相似文献7.
Xiao-Qian Xu Li Zhang Shang-Ying Hu Feng Chen Xun Zhang Qin-Jing Pan Wen-Hua Zhang Rui-Mei Feng Li Dong Qian Zhang Jun-Fei Ma Catherine Sauvaget Fang-hui Zhao You-Lin Qiao Rengaswamy Sankaranarayanan 《Lancet》2017
Background
Comprehensive long-term evaluation for self-collected human papilloma virus (HPV) testing is not well established. We aimed to assess its predictive capacity from a long-term perspective compared with other cervical cancer mainstream screening methods.Methods
1997 women aged 35–45 years from Shanxi, China were screened by self-collected HPV testing, doctor-collected HPV testing, liquid based cytology, and visual inspection with acetic acid in 1999. The women were followed up in 2005, 2010, and 2014 with doctor-collected HPV testing, liquid based cytology, and visual inspection with acetic acid (except in 2014). On the basis of baseline screening results, we calculated cross-sectional and prospective clinical performance and 15-year cumulative incidence rates (CIRs) of cervical intraepithelial neoplasia grade 2 or higher (CIN2+).Findings
Incident sensitivities for CIN2+ of all methods decreased with time, whereas incident specificity remained stable. Self-collected HPV testing predicted 84·2%, 53·2%, and 43·4% CIN2+ incident cases in 2005, 2010, and 2014, respectively, showing no significant difference with doctor-collected HPV testing and cytology at cutoff atypical squamous cells of undetermined significance (ASC-US), but higher than cytology (p=0·008, 0·004 and 0·008) and visual inspection with acetic acid (p=0·004, 0·003, 0·029) at cutoff low-grade squamous intraepithelial lesions at follow-up in 2005, 2010, and 2014, respectively. The difference of incident sensitivity between self-collected HPV testing and cotest was comparable until at 15-year follow-up (43·4% vs 56·6%, p=0·006). Women with baseline-positive self-collected HPV testing showed comparable CIN2+ CIRs with those women who were baseline-positive by doctor-collected HPV testing during 15-year follow-up, but higher than cytology at cutoff ASC-US (p=0·004), cotest (p<0·0001), and visual inspection with acetic acid (p<0·0001). The assurance provided by baseline negative results of self-collected HPV testing was better than visual inspection with acetic acid (p=0·006) and comparable with other screening methods.Interpretation
Self-collected HPV testing showed comparable longitudinal performance to doctor-collected HPV testing and cytology, indicating an alternative role in primary cervical cancer screening. Self-collected HPV with 5 year interval could be an option.Funding
National Natural Science Foundation of China (81322040) and Chinese Academy of Medical Sciences Initiative for Innovative Medicine (CAMS-I2M-1-019). 相似文献8.
9.
Hong-Da Chen Ni Li Jian-Song Ren Yue-Ming Zhang Shuang-Mei Zou Zhao-Xu Zheng Ju-Fang Shi Kai Zhang Jie He Min Dai 《Lancet》2017
Background
Screening for colorectal cancer is effective in reducing the burden of this disease. The measure of adherence is crucial in determining the magnitude of the health impact of screening for colorectal cancer at a population level. We aimed to assess adherence of screening colonoscopy and its influencing factors in a population-based programme of colorectal cancer screening in China.Methods
This study was done under the framework of Screening Program in Urban China supported by the central government of China. Urban permanent residents of aged 40–69 years were defined as the eligible population for the cancer screening programme. Eligible participants were invited to fill an epidemiological questionnaire survey for assessment of cancer risk based on Harvard Cancer Risk Index, and those who were assessed to be at high risk of colorectal cancer were recommended to take a screening colonoscopy. We collected detailed questionnaires and colonoscopy reports. For this analysis, we used research data for 2012–14. We applied logistic regression to identify potential factors associated with the adherence to screening colonoscopy. This study was approved by the Institutional Review Board of the Cancer Hospital of Chinese Academy of Medical Sciences. Written informed consent was obtained from each participant in the study.Findings
Overall, 97?445 participants were assessed to be potentially at high risk of colorectal cancer in 2012–14. 14?949 (15·3%) of the high-risk population followed the recommendation of undertaking screening colonoscopy. Adherence rates varied greatly across the 12 participating provinces, ranging from 7·9% to 26·2%. We noted a significantly higher adherence rate in 2013–14 (17·0%, 9766 of 57?280 participants) than in 2012–13 (12·9%, 5183 of 40?165 participants). After adjusting potential confounding factors, past positive result of fecal occult blood test (odd ratio 1·40, 95% CI 1·31–1·49), previous polyp detection (1·44, 1·38–1·50), inflammatory bowel disease (1·63, 1·56–1·69), and family history of colorectal cancer (1·59, 1·53–1·66) were found to be associated with the adherence to screening colonoscopy.Interpretation
The adherence rate of screening colonoscopy is low in a population-based screening programme in China. Adoption of effective primary screening modalities to precisely identify high-risk population and carrying out health promotion campaigns would be necessary to improve the adherence to screening colonoscopy in China.Funding
The National Health and Family Plan Committee of China. 相似文献10.
11.
Background
The fast ageing of the general population in China will increase the demand for blood products, which may lead to a severe imbalance between blood supply and demand. This study aims to predict the changes in blood supply and demand by 2035 in China.Methods
Based on data from the China Statistical Yearbook (2016), blood transfusion industry development report of China (2016 and 2017), and blood demand information of a tertiary hospital the per person blood supply and demand for different age groups were calculated, which were then, together with the predicted population structure, used to predict blood supply and demand trends between 2015 and 2035. All predictions were made assuming a relatively stable per capita blood supply and demand, enabling the influence of demographic changes on future blood supply and demand to be analysed. Sensitivity analysis was conducted to assess the impact of some other factors on the predicted blood supply and demand.Findings
According to our predictions, blood demand was likely to exceed supply at around 2016, and the widening gap between supply and demand would reach 2·5?×?106 L by 2035, with a 15% decrease in blood supply and a 43% increase in demand. In addition, the magnitude of increase in blood demand is predicted to rise with age groups, with the highest growth rate in blood demand predicted in the 80 years and above age group (123%). After taking a 5·95% blood discard rate into consideration, the gap is predicted to increase to 2·8?×?106 L by 2035. The results of sensitivity analysis reveal the annual increase in blood supply required to meet blood demand in the next 20 years, with a lowest predicted rate of 1·64%. and a highest predicted rate of 2·25%.Interpretation
Compared with other developed countries, China will come under even greater pressure of the imbalance between blood supply and demand and it is imperative to implement new strategies and measures to solve future blood supply and demand problems.Funding
This work was supported by the CAMS Innovation Fund for Medical Sciences (CIFMS) (number 2016-I2M-3-024). 相似文献12.
Ai-lin Zhao Yi-ning Wang Feng-Dan Wang Na Niu Jian Sun Yue-ying Mao Dao-bin Zhou Jian Li Xin-xin Cao 《The Canadian journal of cardiology》2018,34(12):1688.e9-1688.e11
Erdheim-Chester disease (ECD) is a rare non-Langerhans histiocytosis and inflammatory myeloid neoplasm with poor prognosis. Symmetric long bone osteosclerosis occurs in nearly all patients, but other organs are often involved. Coronary artery involvement is rare, but was encountered in a patient who experienced angina. Radiologic presentation and histologic findings were consistent with diagnosis of ECD. A soft-tissue mass was found surrounding the right atrium, ascending aorta, and all branches of coronary artery. Interferon-alfa treatment was successful. In conclusion, we recommend coronary artery computed tomography angiography for cardiovascular evaluation of ECD and interferon-alfa to treat ECD. 相似文献
13.
Background
Catastrophic health expenditure (CHE) is an official indicator measuring the financial risk protection of universal health coverage (UHC) in the era of Sustainable Development Goals. China reports basic medical insurance coverage for more than 95% of its population, but little is known about how CHE incidence and CHE determinants vary across China. Therefore, we aimed to measure CHE incidence and CHE determinants in five provinces across China.Methods
Data were obtained from the subsample of China Family Panel Studies (CFPS) conducted in five provinces of China in 2014, with sample sizes from each province ranging from 907 to 1480. We defined CHE as the point at which annual household out-of-pocket medical expenditure exceeded 10% or 25% of the annual ability to pay, in the 12 months preceding the survey. Ability to pay was defined by the total household income or total expenditure, whichever was highest. We applied binary logistic regression for each province on CHE incidence at 10% and 25% thresholds, controlling for the gender of the head of the household, household income, family member age structure, a family member with non-communicable disease or at least one family member hospitalised, and medical insurance type.Findings
Provincial weighted CHE incidence at 10% and 25% thresholds were 26·5% and 11·7% in Liaoning (Northeast China), 15·1% and 6·1% in Shanghai (East China), 28·4% and 14·3% in Henan (Central China), 20·6% and 8·3% in Guangdong (South China), and 33·0% and 15·3% in Gansu (Northwest China). The odds ratio of groups with different characteristics experiencing CHE varied across the five provinces. For example, when CHE was defined by a 10% threshold, having at least one member hospitalised was associated with CHE incidence, with odds ratios ranging from 2·80 to 7·14 (p<0·0001 for all five provinces).Interpretation
Considerable variation in CHE incidence in different provinces demonstrates that financial risk protection of UHC varies across China. To ‘leave no one behind’, the central government may increase fiscal transfers to poor provinces, like Gansu, to increase the province's ability to protect households from CHE. Additionally, provincial governments need to take targeted action to address the within-province CHE disparities among different social groups.Funding
No funding. 相似文献14.
Xin-xin Cao Zhuang Tian Lu Lin Jian Sun Wei Su Dao-bin Zhou Jian Li 《The Canadian journal of cardiology》2018,34(3):343.e1-343.e3
Cryoglobulinemic vasculitis is a rare and frequently fatal type of myocarditis. Cardiac manifestations in type 1 cryoglobulinemic vasculitis have never been reported to our knowledge. We report a rare case of type 1 cryoglobulinemic vasculitis with cardiac involvement in a patient who experienced progressive heart failure during the diagnosis. The diagnosis was made by the presence of cryoglobulins and endomyocardial biopsy results. After bortezomib-containing treatments, plasma cryoglobulin levels returned to normal, and the patient's clinical condition gradually improved. 相似文献
15.
Maigeng Zhou Jing Liu Yingying Jiang Fan Mao Yichong Li Yan Zhang Yong Jiang Shiwei Liu Jianqun Dong Dong Zhao Linhong Wang Yong Huo Junbo Ge 《Lancet》2018
Background
Sub-regions of China vary greatly in economic status and health resources. A comprehensive approach is needed to evaluate regional cardiovascular health status. The purpose of this study was to evaluate the status of prevention and treatment of cardiovascular disease (CVD) in different provinces across China through the application of the China Cardiovascular Health Index.Methods
A comprehensive evaluation index—China Cardiovascular Health Index (CHI)—was developed through literature review, Delphi method, and Analytic Hierarchy Process, which included 52 indicators from five domains (prevalence of CVD, exposure to risk factors, prevention and control of risk factors, treatment of CVD, and public health policy and service capacity). Data related to the indicators were collected from several sources, including national surveillance, surveys, registration systems, and scientific research. Standard normal transformation was used to calculate the score of each indicator, and the total CHI score was summarised through accumulation of scores of the 52 indicators multiplied by their corresponding index weights. The CHI score ranged from 0 to 100.Findings
The overall CHI for China in 2017 was 49·38, varying from 30·17 to 75·37 across all the sub-regions except Hong Kong, Macao, and Taiwan (for which data were not obtained). Among the 31 provinces, Beijing had the highest CHI score and Tibet had the lowest. The three provinces with the highest scores were Beijing (75·37), Shanghai (75·33), and Zhejiang (74·40), whereas the three with the lowest scores were Tibet (30·17), Guizhou (32·48), and Heilongjiang (33·63).Interpretation
The CHI provides a means to assess cardiovascular health and identify strong and weak aspects of prevention and treatment of CVD in certain provinces in China. Targeted strategies and specific policies can be developed and recommended to improve CVD health status.Funding
National Key R&D Program of China (2017YFC1310902). 相似文献16.
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Peixun Zhang Jia Li Na Han Hui Xin Liu Mengqian Jiang Feng Pan Yali Mu Jiabao Ju Zhan Cheng Gao Baoguo Jiang 《Lancet》2018
Background
Severe acute respiratory syndrome (SARS) broke out in China and spread to all over the world in 2003. Without comprehensive protection, during a severe hospital outbreak in the Peking University People's Hospital (PKUPH), there were 78 patients diagnosed with SARS and two deaths. During treatment, most patients received large doses of steroid shock therapy, which may result in complications of femoral head necrosis and pulmonary fibrosis. We aimed to follow up the condition of lung and bone in those patients.Methods
We did an observational cohort study of patients with SARS from 2003 to 2018. We carried out pulmonary CT scans, hip joint MRI tests, pulmonary function tests, and hip joint functional assessment to evaluate the recovery condition of lung damage and femoral head necrosis according to patients' willingness. We used linear regression, and mixed-model repeated-measures analysis to measure the change of lung interstitial and femoral head necrosis volume. This study was authorised by the Ethics Committee of Peking University People's Hospital (2018PHB010-01). All recruited SARS patients signed informed consent for the study. This study is registered with ClinicalTrials.gov, number NCT03443102.Findings
There were 80 medical staff patients with SARS altogether in Peking University People's Hospital. Two patients died of SARS in 2003 and 78 patients were enrolled in this study from August, 2003, to March, 2018. 71 patients completed the 15 years' follow-up and seven patients were missing. Pulmonary injury scope on lung CT improved from 2003 (9·40%, SD 7·83) to 2004 (3·20%, 4·78; p≤0·001), and thereafter remained steady to 2018 (4·60%, 6·37). Pulmonary function items in patients with SARS did not differ between 2006 and 2018. The recovery extent of pulmonary function items between 2006 and 2018 in patients with lung interstitial change (n=13), was less than that without lung interstitial changes (n=23), especially in one-second ratio (FEV1/FVC, t=2·21, p=0·04) and mid-flow of maximum expiration (FEF25–75%, t=2·76, p=0·01). The volume of femoral head necrosis decreased significantly from 2003 (38·83%, SD 21·01) to 2005 (30·38%, 20·23; p=0·0002), then decreased slowly from 2005 to 2013 (28·99%, 20·59) and thereafter remained steady to 2018 (25·52%, 15·51)%.Interpretation
Damaged lung interstitial and functional decline induced by SARS mainly recovered in the next 1–2 years after rehabilitation. The natural process of femoral head necrosis caused by large doses of steroid shock therapy in SARS patients was not progressive, while partially reversible.Funding
Chinese National Ministry of Science and Technology 973 Project (number 2014CB542201), Beijing science and technology new star cross subject (2018019), Fund for Fostering Young Scholars of Peking University Health Science Center (BMU2017PY013), National Natural Science Foundation (numbers 31771322,31571235, 31571236, 31271284). 相似文献18.
Background
Studies on the patterns of multimorbidity in nationwide older Chinese population are scarce. This study aimed to analyse the current status of multimorbidity among older Chinese people and to explore their multimorbidity patterns.Methods
This cross-sectional study used data from the China Health and Retirement Longitudinal Study collected between 2011 and 2015. Participants aged 50 years or older with demographic and health records were included in this study. Patterns of multimorbidity were explored using hierarchical cluster analysis stratified by gender and region (south vs north, defined by the Qinling-Huai River).Findings
16?965 (99·7%) of 17?021 participants had correct demographic and health record data and were eligible for inclusion in our study. The mean age of all participants was 62·3 years (SD 8·79), and 8483 (50%) of 16 965 participants were women. Of the 17 chronic diseases or conditions included, the overall prevalence ranged from 0·99% (n=167) for cancer to 33·71% (n=5712) for arthritis. 6506 (44%) of the 14?938 participants with complete disease data had two or more chronic diseases or conditions. The prevalence of multimorbidity was significantly different between regions (χ2 16·35, p<0·0001) and sexes (χ2 81·41, p<0·0001). Five consistent multimorbidity patterns were identified across all sex and region strata: metabolic cluster, hepatorenal cluster, respiratory cluster, cerebral cluster, and stomach-arthritis cluster. Some heterogeneity was observed for the composition of multimorbidity clusters across sex and region strata. A stomach-arthritis cluster was assembled with a hepatorenal cluster in the north, but the two clusters were separated in the south. For women, a cardiopulmonary cluster, including heart and respiratory problems, was seen in the north, whereas a cardiometabolic cluster occurred in the south. For men, four multimorbidity clusters (cerebral-cardiometabolic cluster, hepatorenal-stomach cluster, respiratory-skeletal-glaucoma cluster, and stomach-arthritis cluster) occurred in the south, whereas five clusters (cardiometabolic cluster, cerebral-skeletal cluster, hepatorenal-stomach-arthritis cluster, respiratory cluster, and ophthalmic-cancer cluster) occurred in the north.Interpretation
Our results show that the prevalence and patterns of multimorbidity varies by sex and region among older Chinese people, which might be explained by socioeconomic, environmental, and demographic factors. Although our study is limited by the self-reported chronic diseases or conditions, our findings are useful for the identification of preventative strategies for each specific subgroup of patients showing a particular multimorbidity pattern.Funding
National Natural Science Foundation of China. 相似文献19.
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