ArticleInternational journal for equity in health2023
20-year trends in multimorbidity by race/ethnicity among hospitalized patient populations in the United States.
Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Association of multimorbidity trajectories from early adulthood through middle age with middle-age physical function.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Cohort Changes in Cognitive Function Among Mexican Older Adults from 2001 to 2021.The Gerontologist · 2025Article
- Intersectional and Marginal Debiasing in Prediction Models for Emergency Admissions.JAMA network open · 2025Article
- Association Between Race and Comorbid Conditions Among Older Adults with Dementia.Journal of clinical medicine · 2024Article
- Trends in Diverticular Disease Hospitalizations and Racial Disparities in Outcomes Across the United States.Cureus · 2024Article
- Experiences of and reactions to race-based differential treatment with multiple chronic conditions by race: Evidence from the South Carolina behavioral risk factor surveillance systems surveys prior to the COVID-19 pandemic.Journal of multimorbidity and comorbidityArticle
- Changes in multimorbidity among hospitalized adults in the US.Journal of multimorbidity and comorbidityArticle
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Authors and funding
7 authors.
Funding
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Abstract
backgroundThe challenges presented by multimorbidity continue to rise in the United States. Little is known about how the relative contribution of individual chronic conditions to multimorbidity has changed over time, and how this varies by race/ethnicity. The objective of this study was to describe trends in multimorbidity by race/ethnicity, as well as to determine the differential contribution of individual chronic conditions to multimorbidity in hospitalized populations over a 20-year period within the United States.
methodsThis is a serial cross-sectional study using the Nationwide Inpatient Sample (NIS) from 1993 to 2012. We identified all hospitalized patients aged ≥ 18 years old with available data on race/ethnicity. Multimorbidity was defined as the presence of 3 or more conditions based on the Elixhauser comorbidity index. The relative change in the proportion of hospitalized patients with multimorbidity, overall and by race/ethnicity (Black, White, Hispanic, Asian/Pacific Islander, Native American) were tabulated and presented graphically. Population attributable fractions were estimated from modified Poisson regression models adjusted for sex, age, and insurance type. These fractions were used to describe the relative contribution of individual chronic conditions to multimorbidity over time and across racial/ethnic groups.
resultsThere were 123,613,970 hospitalizations captured within the NIS between 1993 and 2012. The prevalence of multimorbidity increased in all race/ethnic groups over the 20-year period, most notably among White, Black, and Native American populations (+ 29.4%, + 29.7%, and + 32.0%, respectively). In both 1993 and 2012, Black hospitalized patients had a higher prevalence of multimorbidity (25.1% and 54.8%, respectively) compared to all other race/ethnic groups. Native American populations exhibited the largest overall increase in multimorbidity (+ 32.0%). Furthermore, the contribution of metabolic diseases to multimorbidity increased, particularly among Hispanic patients who had the highest population attributable fraction values for diabetes without complications (15.0%), diabetes with complications (5.1%), and obesity (5.8%).
conclusionsFrom 1993 to 2012, the secular increases in the prevalence of multimorbidity as well as changes in the differential contribution of individual chronic conditions has varied substantially by race/ethnicity. These findings further elucidate the racial/ethnic gaps prevalent in multimorbidity within the United States. PRIOR PRESENTATIONS: Preliminary finding of this study were presented at the Society of General Internal Medicine (SGIM) Annual Conference, Washington, DC, April 21, 2017.
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