JMIR Publications

ABSTRACT

Background:

Multimorbidity was evaluated from the co-occurrence of two or more chronic diseases based on self-reported medical diagnosis.

Objective:

This study aims to investigate the dynamic distribution of multimorbidity cross socio-demographic and its impacts on health-related issues over 15 years using Brazil’s national data.

Methods:

Descriptive statistics, hypothesis tests, and logistic regression analysis were calculated. The study sample was composed of 679,572 adults (18-59 years of age) and 115,699 elderly people (≥60 years of age) from two latest cross-sectional, multiple-cohort, national-based studies: The National Sample Household Survey (PNAD) of 1998, 2003 and 2008, and the Brazilian National Health Survey (PNS) of 2013.

Results:

Overall, the risk of multimorbidity in adults was 1.7 times higher in women (OR=1.73; 95%CI: 1.67-1.79) and 1.3 times higher among illiterates (OR=1.34; 95%CI:1.28-1.41). We confirm that multiple chronic diseases grow considerably with age in Brazil, and people between 50 and 59 years old had about twelve times more chance of multimorbidity than adults between 18 and 29 years of age (OR=11.89; 95%CI: 11.27-12.55). Seniors with multimorbidity had more than twice the chance of receiving health assistance in community services or clinics (OR=2.16; 95%CI: 2.02-2.31) and to be hospitalized (OR=2.37; 95%CI: 2.21-2.56). The subjective well-being of adults with multimorbidity was often worse than people without multiple chronic diseases (OR=12.85; 95%CI: 12.07-13.68). These patterns are similar across all four cohorts analysed and were relatively stable over 15 years.

Conclusions:

Despite medical knowledge and skills are improved continuously over time, our study indicates little variation in the prevalence of chronic diseases in Brazil. The analysis of multimorbidity from the two latest Brazil national surveys will support policy-making on epidemic prevention and management.