Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study
Background Multimorbidity (two or more concurrent chronic conditions) is associated with poorer health outcomes and increased healthcare utilisation in primary care and general populations. Less is known about the prevalence of multimorbidity in emergency department attenders, or its association wit...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-12-01
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| Series: | Journal of Multimorbidity and Comorbidity |
| Online Access: | https://doi.org/10.1177/26335565221147417 |
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| author | Chris McParland Mark A Cooper David J Lowe Bethany Stanley Bridget Johnston |
| author_facet | Chris McParland Mark A Cooper David J Lowe Bethany Stanley Bridget Johnston |
| author_sort | Chris McParland |
| collection | DOAJ |
| description | Background Multimorbidity (two or more concurrent chronic conditions) is associated with poorer health outcomes and increased healthcare utilisation in primary care and general populations. Less is known about the prevalence of multimorbidity in emergency department attenders, or its association with poor outcomes in this population. Aim This study sought to explore the relationship between multimorbidity, mortality and health-care utilisation in a large urban cohort of persons attending emergency departments. Methods Validated algorithms for the identification of 28 chronic conditions from ICD-10 codes were deployed on a cross-sectional sample of patients attending emergency departments in Glasgow, Scotland between April 2019 and March 2020. Analysis was conducted on complete cases (n=63,328) and compared with results from data with imputed missing values (n=75,723). Models adjusted for age, sex, deprivation and ethnicity were fitted to test for the association between (i) multimorbidity, (ii) complex multimorbidity, (iii) disease count and the following outcomes: admission to hospital, reattendance at 30 and 90 days, and death during admission. Results Multimorbidity, complex multimorbidity and disease count were significantly associated with hospital admission and emergency department reattendance. Those with 1-3 conditions were at increased risk of inpatient mortality. Conclusion This study further evidences the impact of multimorbidity and disease burden on health-care use, and mortality to a lesser extent. Deployed algorithms were sufficiently sensitive to detect associations, despite limited access (21 months) to secondary-care data. This should allow for the construction of more robust models to prospectively identify persons at risk of poor outcomes in similar populations. |
| format | Article |
| id | doaj-art-45aabe2b1dc144a58d52c0e1fff64215 |
| institution | OA Journals |
| issn | 2633-5565 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Multimorbidity and Comorbidity |
| spelling | doaj-art-45aabe2b1dc144a58d52c0e1fff642152025-08-20T02:27:49ZengSAGE PublishingJournal of Multimorbidity and Comorbidity2633-55652022-12-011210.1177/26335565221147417Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage studyChris McParlandMark A CooperDavid J LoweBethany StanleyBridget JohnstonBackground Multimorbidity (two or more concurrent chronic conditions) is associated with poorer health outcomes and increased healthcare utilisation in primary care and general populations. Less is known about the prevalence of multimorbidity in emergency department attenders, or its association with poor outcomes in this population. Aim This study sought to explore the relationship between multimorbidity, mortality and health-care utilisation in a large urban cohort of persons attending emergency departments. Methods Validated algorithms for the identification of 28 chronic conditions from ICD-10 codes were deployed on a cross-sectional sample of patients attending emergency departments in Glasgow, Scotland between April 2019 and March 2020. Analysis was conducted on complete cases (n=63,328) and compared with results from data with imputed missing values (n=75,723). Models adjusted for age, sex, deprivation and ethnicity were fitted to test for the association between (i) multimorbidity, (ii) complex multimorbidity, (iii) disease count and the following outcomes: admission to hospital, reattendance at 30 and 90 days, and death during admission. Results Multimorbidity, complex multimorbidity and disease count were significantly associated with hospital admission and emergency department reattendance. Those with 1-3 conditions were at increased risk of inpatient mortality. Conclusion This study further evidences the impact of multimorbidity and disease burden on health-care use, and mortality to a lesser extent. Deployed algorithms were sufficiently sensitive to detect associations, despite limited access (21 months) to secondary-care data. This should allow for the construction of more robust models to prospectively identify persons at risk of poor outcomes in similar populations.https://doi.org/10.1177/26335565221147417 |
| spellingShingle | Chris McParland Mark A Cooper David J Lowe Bethany Stanley Bridget Johnston Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study Journal of Multimorbidity and Comorbidity |
| title | Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study |
| title_full | Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study |
| title_fullStr | Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study |
| title_full_unstemmed | Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study |
| title_short | Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study |
| title_sort | multimorbidity disease count mortality and emergency care use in persons attending the emergency department a cross sectional data linkage study |
| url | https://doi.org/10.1177/26335565221147417 |
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