ArticleBMC medicine2014
Epidemiology of multimorbidity in China and implications for the healthcare system: cross-sectional survey among 162,464 community household residents in southern China.
Article in BMC medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 142 papers, 7 of them syntheses that pooled it.
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Who cites it
142 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Barriers to Community-Based Primary Health Care Delivery in Urban China: A Systematic Mapping Review.International journal of environmental research and public health · 2022Pooled it
- Community prevalence and dyad disease pattern of multimorbidity in China and India: a systematic review.BMJ global health · 2022Pooled it
- Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis.Age and ageing · 2022Pooled it
- Multimorbidity of non-communicable diseases in low-income and middle-income countries: a systematic review and meta-analysis.BMJ open · 2022Pooled it
- Factors associated with potentially inappropriate prescriptions and barriers to medicines optimisation among older adults in primary care settings: a systematic review.Family medicine and community health · 2021Pooled it
- Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis.American journal of hypertension · 2020Pooled it
- Factors influencing choice of health system access level in China: A systematic review.PloS one · 2018Pooled it
- Distribution, inequalities and associated factors of unmet medical needs among older adults: evidence from the national health service survey.BMC geriatrics · 2026Article
- Medication adherence among geriatric patients with chronic diseases in rural China: a social ecological model perspective.BMC geriatrics · 2026Article
- Assessment of Factors Associated with Treatment Adherence Among Elderly Patients with Multimorbid Type 2 Diabetes Mellitus Using Lasso-Logistic Regression.Patient preference and adherence · 2026Article
- Quality of life and associated factors among people with chronic diseases in Hubei, China: a cross-sectional study.BMC public health · 2025Article
- Sex- and age-specific multimorbidity networks in middle-aged inpatients: a network-based comparative study between China and the United Kingdom.Innovation in aging · 2025Article
- Prevalence of multimorbidity and its relationship with socioeconomic status among Chinese older adults over time.PloS one · 2025Article
- Multimorbidity measures associated with cognitive function among community-dwelling older Chinese adults.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Trends in prevalence of multimorbidity for chronic diseases in China: serial cross-sectional surveys from 2009 to 2018.The journal of nutrition, health & aging · 2024Article
- Association between dietary branched-chain amino acids and multiple chronic conditions among older adults in Chinese communities.Nutrition & metabolism · 2024Article
- Multimorbidity patterns and health-related quality of life among community-dwelling older adults: evidence from a rural town in Suzhou, China.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Multistate survival modelling of multimorbidity and transitions across health needs states and death in an ageing population.Journal of epidemiology and community health · 2024Article
- Bidirectional associations between sleep quality/duration and multimorbidity in middle-aged and older people Chinese adults: a longitudinal study.BMC public health · 2024Article
- Nutrient intake and risk of multimorbidity: a prospective cohort study of 25,389 women.BMC public health · 2024Article
82 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChina, like other countries, is facing a growing burden of chronic disease but the prevalence of multimorbidity and implications for the healthcare system have been little researched. We examined the epidemiology of multimorbidity in southern China in a large representative sample. The effects of multimorbidity and other factors on usual source of healthcare were also examined.
methodsWe conducted a large cross-sectional survey among approximately 5% (N = 162,464) of the resident population in three prefectures in Guangdong province, southern China in 2011. A multistage, stratified random sampling was adopted. The study population had many similar characteristics to the national census population. Interviewer-administered questionnaires were used to collect self-report data on demographics, socio-economics, lifestyles, healthcare use, and health characteristics from paper-based medical reports.
resultsMore than one in ten of the total study population (11.1%, 95% confidence interval (CI) 10.6 to 11.6) had two or more chronic conditions from a selection of 40 morbidities. The prevalence of multimorbidity increased with age (adjusted odds ratio (aOR) = 1.36, 95% CI 1.35 to 1.38 per five years). Female gender (aOR = 1.70, 95% CI 1.64 to 1.76), low education (aOR = 1.26, 95% CI 1.23 to 1.29), lack of medical insurance (aOR = 1.79, 95% CI 1.71 to 1.89), and unhealthy lifestyle behaviours were independent predictors of multimorbidity. Multimorbidity was associated with the regular use of secondary outpatient care in preference to primary care.
conclusionsMultimorbidity is now common in China. The reported preferential use of secondary care over primary care by patients with multimorbidity has many major implications. There is an urgent need to further develop a strong and equitable primary care system.
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