Defining Comorbidity: Implications for Understanding Health and Health Services
By J. Valderas, B. Starfield, B. Sibbald, C. Salisbury, M. Roland. Annals of Family Medicine, 2009
1,651 citations recorded by the source corpus.
Comorbidity is associated with worse health outcomes, more complex clinical management, and increased health care costs. There is no agreement, however, on the meaning of the term, and related constructs, such as multimorbidity, morbidity burden, and patient complexity, are not well conceptualized. In this article, we review definitions of comorbidity and their relationship to related constructs. We show that the value of a given construct lies in its ability to explain a particular phenomenon of interest within the domains of (1) clinical care, (2) epidemiology, or (3) health services planning and financing. Mechanisms that may underlie the coexistence of 2 or more conditions in a patient (direct causation, associated risk factors, heterogeneity, independence) are examined, and the implications for clinical care considered. We conclude that the more precise use of constructs, as proposed in this article, would lead to improved research into the phenomenon of ill health in clinical care, epidemiology, and health services.
Subfields: Economics and Econometrics, Epidemiology, General Health Professions
View Paper: https://www.semanticscholar.org/paper/f7ecc848e8c8ef5192735c6879ff1159f4d8e83d
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Citations in the corpus
- Review: Health Care Utilization and Costs of Elderly Persons With Multiple Chronic Conditions (2011, background): “Depending on the nature of the interactions among coexisting diseases, HCCs could either be greater or less than the sum of the cost of individual diseases (Valderas et al., 2009).”
- Personalized Prescription for Comorbidity (2018, background): “In the United States, about 80% of medicare costs are caused by patients with 4 or more chronic diseases [8].”
- Ageing and the epidemiology of multimorbidity (2014, background): “First, that comorbidity as observed in many epidemiological studies and reports does not necessarily reflect a causal association between diseases, as it may result from chance and bias [9].”
- Prevalence, Determinants and Patterns of Multimorbidity in Primary Care: A Systematic Review of Observational Studies (2014, background): “Multimorbidity 2 the presence of more than one health condition in an individual [1,2] 2 is increasingly being recognised as the norm rather than the exception in primary care patients [3].”
- Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design? (2010, background): “Multimorbidity needs to be considered within the context of a person, or patient.(25,35) The person with multimorbidity also has individual values and priorities for their life and healthcare, which need to be elicited and factored into treatment plans.”
- Comorbidity of compulsive buying and brand addiction: An examination of two types of addictive consumption (2020, background): “explicit ordering, or one leads to the development of the other (Angold et al., 1999; Feinstein, 1970; Krahn, 1991; Spitzer, 1994; Valderas et al., 2009).”
- Attentive State-Space Modeling of Disease Progression (2019, methodology): “This renders HMM-based models incapable of properly explaining the heterogeneity in the patients’ progression trajectories, which often results from their varying clinical histories or the chronologies (timing and order) of their clinical events [5].”