engleski

Multimorbidity and associated risk factors in the "work active" population in social deprived areas of Croatia - a pilot study

Background: Multimorbidity (MM) of chronic diseases (CD) in 21st century is becoming a major problem even in younger age population (<65). Social deprivation, economical crisis, harmful habits are making this problem even more difficult in the areas of Croatia devastated in the war for independence. Research question: Explore the frequency of presence of MM of CD, social-economical factors and harmful habits of smoking and alcohol abuse, and medical services utilisation by the work-active population in socio-economically deprived areas in Croatia. Method: During 2011 we conducted a retrospective research on prevalence and characteristics of CD multimorbidity of 1616 working population subjects (age 18-65) in GP practice in town Orahovica, region of East Slavonia. Multimorbidity was defined as the presence of 2 or more CD in the patients, and data of all noticed CD based on ICDX classification were collected from e-medical records. Out of 1616 examinees, 1218 (75, 4%) of were chronically ill patients (monomorbidity 572(47, 6%), and multimorbidity 646 (53, 0%)). For the purpose of our pilot-study we sampled every third chronic patient with CD multi-morbidity ((220 examinees, 113(51, 4%) women and 107(48, 6% men)).Collected were social-demographic data, data on economical status, all listed CD diagnosis, smoking and alcohol abuse, employment status, medical services usage and sick-leave absence in 2011. Results: 220 examinees with multi-morbidity had 678 CD diagnoses (average 3, 1 per examinee), and diagnostic groups included: mental 208(30, 6%), cardiovascular 160(23, 6%) and musculoskeletal 93 (13, 7%). Unemployed were 92(42, 3%), on disability 75(32, 7%) and employed 53(25, 0%).While low social-economical status had 50(22, 7%) subjects, only 11(5%) had high social-economical status. 50% were alcohol abusers, and 64, 5% smokers. Employed people averaged sick-leave absence at 24, 7 days per year. Conclusions: Very high frequency of CD multi-morbidity, negative social-economical factors, multiple health risk factors and high utilization of medical service emphasizes complexity of medical care to work-active population in social-economical deprived areas of Croatia.

multimorbidity; work active population; socioeconomic; risk factors; family medicine

European Journal of General Practice, 2013 ; 19:162-184.