Antje van der Zee-Neuen
Msc,Polina Putrik Msc, Sofia Ramiro MD, Phd, Andras Keszei Phd, Rob
de Bie Phd, Astrid Chorus Phd and Annelies Boonen MD, Phd
Arthritis Care & Research
DOI: 10.1002 / acr.22913
Arthritis Care & Research
DOI: 10.1002 / acr.22913
Objetivos
Las enfermedades crónicas
son cada vez más frecuentes y, a menudo se producen como
multimorbilidad. Este estudio compara el impacto de los trastornos
musculoesqueléticos (MSKD) en costos de salud y de asistencia
sanitaria con otras enfermedades crónicas y evalúa el impacto
adicional de los MSKD en estos resultados cuando se producen como
parte de multimorbilidad
Métodos
Una encuesta de hogares en
una muestra aleatoria de la población holandesa (N = 8.904)
proporcionó información sobre factores socio-demográficos, nueve
médicos confirmaron la presencia de enfermedades crónicas
(músculo-esqueléticas, migraña, diabetes, enfermedades
cardiovasculares, cáncer, respiratorias, de la piel, mentales y
gastrointestinales), puntuaciones de los componentes físicos y
mentales del SF-12 (PCS; MCS) y utilización de recursos sanitarios.
La influencia independiente de diferentes enfermedades y el papel de
las MSKD al aumentar el número de morbilidades en PCS / MCS y los
costes sanitarios a 3 meses de la sociedad fueron explorados a través
de regresiones binomiales negativas lineales multivariables y
cero-infladas, respectivamente.
Resultados
El 20% de todos los
sujetos y el 56% de los que tienen multimorbilidad tenían además un
MSKD. MSKD tuvo el mayor impacto en PCS (β = -8,37 [95% IC: -8,84 a
-7,89]), pero ningún impacto significativo sobre MCS. Cuando un MSKD
se produjo como parte de multimorbilidad, se observó una
amplificación del efecto adverso sobre PCS pero no en MCS, con
independencia del número de comorbilidades. Los MSKD fueron los
responsables de un aumento de 2 veces en los costos (Exp (β) = 2,27
[2,08-2,51]), que fue el segundo aumento de costo más alto de todas
las enfermedades (después del cáncer). Una amplificación
significativa de los costes se observó cuando se produjo la
coexistencia de MSKD con enfermedades mentales.
Conclusión
Los MSKD a menudo
co-ocurren con otras enfermedades crónicas. En el contexto de
multimorbilidad, la presencia de un MSKD amplifica el impacto sobre
la salud física, en menor medida sobre los costos de salud, pero no
sobre la salud mental.
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