Patterns of Chronic Conditions and Their Association With Visual Impairment and Health Care Use.
JAMA Ophthalmol
; 138(4): 387-394, 2020 04 01.
Article
en En
| MEDLINE
| ID: mdl-32105300
ABSTRACT
Importance Visual impairment and visual disorders often co-occur with other chronic conditions. Understanding patterns of multimorbidity is important for reducing health care use and improving health outcomes. Objective:
To identify chronic condition patterns and their association with visual impairment and health care use in a nationally representative sample. Design, Setting, andParticipants:
This cross-sectional study used National Health Interview Survey data for 387â¯780 individuals aged 18 years and older, representative of the civilian noninstitutionalized US population, from January 1, 2002, to December 31, 2014. Statistical analysis was performed from June to November 2018. Exposures Participants were classified in subgroups with different combinations of self-reported chronic conditions using latent class analysis. Main Outcomes andMeasures:
Self-reported visual impairment, emergency department visit, and hospitalization use in the previous 12 months.Results:
Among the 387â¯780 individuals included in the study, 51.8% were female, 77.6% were white, and the mean (SD) age was 46.2 (18.0) years. Latent class analysis identified 5 different classes, with 70.5% of the participants belonging to the healthy group. The other 4 groups represented various degrees and patterns of multimorbidity. The hypertensive group (19.6%) had a high prevalence of hypertension (62.6%), the respiratory conditions group (4.4%) had a high prevalence of emphysema (47.7%) and asthma (45.6%), the heart disease group (3.6%) had high prevalence of coronary heart disease (69.8%), and the severely impaired group (1.8%) had higher prevalence of most conditions compared with the other groups. In the adjusted analysis, compared with the healthy group, participants in all 4 disease groups had elevated risk of visual impairment heart condition group (odds ratio [OR], 3.19; 95% CI, 2.92-3.48), hypertensive group (OR, 3.28; 95% CI, 3.10-3.48), respiratory condition group (OR, 3.87; 95% CI, 3.56-4.20), and severely impaired group (OR, 10.19; 95% CI, 9.20-11.28). All 4 disease groups had elevated risk of reporting emergency department use and hospitalization. For the severely impaired group, the OR for emergency department use was 9.39 (95% CI, 8.53-10.34), and the OR for hospitalization was 10.80 (95% CI, 9.80-11.92). Conclusions and Relevance In this study, individuals in all 4 multimorbidity groups had an elevated risk of visual impairment and health care use compared with the healthy group. Characteristics of high-risk groups identified by this study may help in the development and implementation of interventions to avert the more serious consequences of having multiple chronic conditions.
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Trastornos de la Visión
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Aceptación de la Atención de Salud
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Enfermedad Crónica
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Personas con Daño Visual
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
JAMA Ophthalmol
Año:
2020
Tipo del documento:
Article