Ten-year population-based assessment of multimorbidity burden progression in a regional cohort of 5.5 million adults
Por:
Valero-Bover, D, Monterde, D, Carot-Sans, G, Vela, E, González-Colom, R, Roca, J, Pontes, C, Michelena, X, Nogueras, MM, Aparicio, P, Corrales, I, Biec, T, Cano, I, Piera-Jiménez, J
Publicada:
31 ene 2026
Resumen:
Multimorbidity, a major driver of healthcare demand and clinical complexity, is often addressed in a disease-centric manner and remains insufficiently understood in its population-level dynamics. Using data from a 10-year population-based cohort of 5.5 million adults in Catalonia, Spain, we quantified multimorbidity-associated clinical complexity using the Adjusted Morbidity Groups (AMG) index to predict progression from low/moderate ( < P-80) to high/very high ( >= P-80) complexity. Machine learning models identified predictive factors, while network analyses explored co-occurrence patterns among chronic conditions. During follow-up, 39.2% of the individuals who remained alive throughout the analysis period transitioned to high/very high complexity. Baseline AMG score was the strongest predictor of progression, surpassing models relying solely on individual diagnoses. The most prevalent conditions were nutritional and endocrine disorders, anxiety, and hypertension, with notable sequential links between mental and physical disorders. Findings emphasize the need for integrated, patient-centred care strategies and population-based prevention approaches to mitigate multimorbidity progression.
Filiaciones:
Valero-Bover, D:
Serv Catala Salut CatSalut, Barcelona, Spain
Digitalizat Sustainabil Healthcare Syst DS3 Res Gr, Barcelona, Spain
Univ Barcelona UB, Dept Med, Barcelona, Spain
Monterde, D:
Digitalizat Sustainabil Healthcare Syst DS3 Res Gr, Barcelona, Spain
Inst Catala Salut ICS, Barcelona, Spain
Carot-Sans, G:
Serv Catala Salut CatSalut, Barcelona, Spain
Digitalizat Sustainabil Healthcare Syst DS3 Res Gr, Barcelona, Spain
Vela, E:
Serv Catala Salut CatSalut, Barcelona, Spain
Digitalizat Sustainabil Healthcare Syst DS3 Res Gr, Barcelona, Spain
González-Colom, R:
Inst Invest Biomed August Pi I Sunyer FRCB IDIBAPS, Fundacio Recerca Clin Barcelona, Barcelona, Spain
Roca, J:
Inst Invest Biomed August Pi I Sunyer FRCB IDIBAPS, Fundacio Recerca Clin Barcelona, Barcelona, Spain
Pontes, C:
Digitalizat Sustainabil Healthcare Syst DS3 Res Gr, Barcelona, Spain
Hosp Santa Creu i St Pau, Serv Farmacol Clin, Barcelona, Spain
Univ Autonoma Barcelona, Dept Farmacol Terapeut & Toxicol, Bellaterra, Spain
Michelena, X:
Serv Catala Salut CatSalut, Barcelona, Spain
Digitalizat Sustainabil Healthcare Syst DS3 Res Gr, Barcelona, Spain
Nogueras, MM:
Digitalizat Sustainabil Healthcare Syst DS3 Res Gr, Barcelona, Spain
Agencia Qualitat & Avaluacio Sanit Catalunya AQuAS, Barcelona, Spain
Aparicio, P:
Minist Hlth, Subdirecc Gen Cal Asistencial, Direcc Gen Salud Publ & Equ Salud, Madrid, Spain
Corrales, I:
Minist Hlth, Subdirecc Gen Cal Asistencial, Direcc Gen Salud Publ & Equ Salud, Madrid, Spain
Biec, T:
Minist Hlth, Subdirecc Gen Cal Asistencial, Direcc Gen Salud Publ & Equ Salud, Madrid, Spain
Cano, I:
Univ Barcelona UB, Dept Med, Barcelona, Spain
Inst Invest Biomed August Pi I Sunyer FRCB IDIBAPS, Fundacio Recerca Clin Barcelona, Barcelona, Spain
Hosp Clin Barcelona, Clin Informat Serv, Barcelona, Spain
Piera-Jiménez, J:
Serv Catala Salut CatSalut, Barcelona, Spain
Digitalizat Sustainabil Healthcare Syst DS3 Res Gr, Barcelona, Spain
Univ Oberta Catalunya, Fac Informat Multimedia & Telecommun, Barcelona, Spain
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