Determinants of Multimorbidity in Bangladesh: a Hospital Based Study
Hasna Hena; Md. Aminul Haque, PhD
Department of Population Sciences, University of Dhaka
Abstract
Background: Multimorbidity among elderly is a major public health problem in most of the developing countries including Bangladesh where the population is moving towards aging. Little is known about multimorbidity in Bangladesh. The aim of the study was to identify the determinants of multimorbidity. Methods: A cross-sectional study was conducted in two tertiary level hospitals in Bangladesh with a sample of 572 adult-s age 60 years and older. The presence of chronic conditions was collected from medical examination reports at the hospital and data on socio-demographic factors was collected using structured questionnaire through an in-person interview. Multimorbidity was defined as the co-occurrence of at least two chronic diseases in one person whether as a coincidence or not.Age, sex, body mass index (BMI), marital status, place of residence, educational level, occupation, economic dependence, smoking, have been hypothesized as potential determinants for multimorbidity.Chi-square test, t-test, multiple linear regression, and multivariable logistic regression models were used to assess the association and the determinants of multimorbidity with the predictor variables where appropriate. Result: The overall prevalence of multimorbidity among elderly was 56.5% and the prevalence was higher among females (64.18 %) than males (54.17 %). The most prevalent conditions were hypertension (33%), diabetes (27.6%), ischaemic heart disease (12.0%), and chronic obstructive pulmonary disease (9%). The risk of multimorbidity increased with the increasing of age (OR: 1.03, CI: 1.04-1.06). Patients from rural areas (OR: 3.25, CI: 2.08-5.06), and economically dependent (OR: 3.82, CI: 2.38-6.13) had a higher risk of having multimorbidity than the patients from urban, not economically dependent patients, respectively. Conclusion: The study suggests that there is an urgent need to develop geriatric health care services by gender, educational status, place of residence. Urgent policy initiatives are needed to address gender, educational status and place of residence specific multimorbidity of the countries with similar socio-eeconomic situation to reduce the burden of multi-morbidity.
Keywords: Multimorbidity; Elderly; Functional Status; Psychological Distress; Health-Related Quality of Life.
Topic: Others