Perceived Stress, Multimorbidity, and Risk for Hospitalizations for Ambulatory Care–sensitive Conditions

Prior, Anders; Vestergaard, Mogens; Davydow, Dimitry S.; Larsen, Karen Kjær; Ribe, Anette Riisgaard; Fenger‐Grøn, Morten

doi:10.1097/mlr.0000000000000632

Cited by 14 publications

(24 citation statements)

References 43 publications

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“…But, because these positive psychologic factors propagate across social groups, these findings may extend to the community level as well, and emerging evidence suggests that higher levels of neighbourhood social well-being are indeed associated with lower levels of perceived chronic stress among residents 52. This logic is further supported by findings from a large population-based cohort study that reported that groups with the highest quintile of perceived stress experienced an approximately 1.5-fold higher risk of hospitalisation for ambulatory sensitive conditions, after adjusting for demographics, predisposing conditions, multimorbidity and socioeconomic factors 64…”

Section: Discussionmentioning

confidence: 65%

Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states

et al. 2019

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ObjectiveTo evaluate the association between community well-being, a positively framed, multidimensional assessment of the health and quality of life of a geographic community, and hospitalisation rates.DesignCross-sectional studySettingZip codes within six US states (Florida, Iowa, Nebraska, New York, Pennsylvania and Utah)Main outcome measuresOur primary outcome was age-adjusted, all-cause hospitalisation rates in 2010; secondary outcomes included potentially preventable disease-specific hospitalisation rates, including cardiovascular-related, respiratory-related and cancer-related admissions. Our main independent variable was the Gallup-Sharecare Well-Being Index (WBI) and its domains (life evaluation, emotional health, work environment, physical health, healthy behaviours and basic access).ResultsZip codes with the highest quintile of well-being had 223 fewer hospitalisations per 100 000 (100k) residents than zip codes with the lowest well-being. In our final model, adjusted for WBI respondent age, sex, race/ethnicity and income, and zip code number of hospital beds, primary care physician density, hospital density and admission rates for two low-variation conditions, a 1 SD increase in WBI was associated with 5 fewer admissions/100k (95% CI 4.0 to 5.8; p<0.001). Results were similar for cardiovascular-related and respiratory-related admissions, but no association remained for cancer-related hospitalisation after adjustment. Patterns were similar for each of the WBI domains and all-cause hospitalisations.Conclusion and relevanceCommunity well-being is inversely associated with local hospitalisation rates. In addition to health and quality-of-life benefits, higher community well-being may also result in fewer unnecessary hospitalisations.

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Section: Discussionmentioning

confidence: 65%

Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states

et al. 2019

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“…One in fifty may not sound as many, but this figure corresponds to almost one patient per week per GP and around 75,000 patients in Denmark during 6 months. Patients with stress often requires several consultations, including examinations of psychological and physical symptoms, talk therapy, introduction and adjustment of pharmaceutical treatment, sick notes and declarations to employer and municipality; psychological stress is associated with high use of both elective and acute services by the GP and in the hospitals [29, 30]. This reflects a substantial burden on society at large and on general practice in specific.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of persons contacting general practice for psychological stress in Denmark

Lykkegaard

Rosendal

Brask

et al. 2018

Scandinavian Journal of Primary Health Care

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A total of 2% of the working-age population contacted the GP during a six-month period for psychological stress. The prevalence of psychological stress varies with age, sex and characteristics of both the regional area and the GP. Key points Psychological stress is a leading cause of days on sick leave, but its prevalence has been based on population surveys rather than on assessment by health care professionals. • This study found that during six months 2.1% of all working-age persons have at least one contact with the GP regarding psychological stress. • The six months prevalence of psychological stress was associated with patient age and sex, GP age and sex, practices' number of GPs and patients per GP, and area education and urbanization level.

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“…ICD‐9 or ICD‐10 diagnosis codes were extracted from both inpatient and outpatient data sources for the majority of the multimorbidity measures (18/22) 2,22–24,26–40,40,41,50–60 . Nine measures extracted supplementary information on diseases from pharmacy data sources, using mostly the Anatomical Therapeutic Chemical Classification System (ATC) code 2,23,27,31,33–39,54–60 . Other databases included death registries 23 and laboratory data 40,41 .…”

Section: Resultsmentioning

confidence: 99%

“…2,23,27,31,[33][34][35][36][37][38][39][54][55][56][57][58][59][60] Other T A B L E 1 Characteristics of multimorbidity measures relying on administrative data using the ICD coding system…”

mentioning

confidence: 99%

Multimorbidity measures from health administrative data using ICD system codes: A systematic review

Simard

Rahme

Calfat

et al. 2021

Pharmacoepidemiology and Drug

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Background: We aimed to identify and characterize adult population-based multimorbidity measures using health administrative data and the International Classification of Diseases (ICD) codes for disease identification.Methods: We performed a narrative systematic review of studies using or describing development or validation of multimorbidity measures. We compared the number of diseases included in the measures, the process of data extraction (case definition) and the validation process. We assessed the methodological robustness using eight criteria, five based on general criteria for indicators (AIRE instrument) and three multimorbidity-specific criteria.Results: Twenty-two multimorbidity measures were identified. The number of diseases they included ranged from 5 to 84 (median = 20), with 19 measures including both physical and mental conditions. Diseases were identified using ICD codes extracted from inpatient and outpatient data (18/22) and sometimes including drug claims (10/22). The validation process relied mainly on the capacity of the measures to predict health outcome (5/22), or on the validation of each individual disease against a gold standard (8/22). Six multimorbidity measures met at least six of the eight robustness criteria assessed. Conclusion:There is significant heterogeneity among the measures used to assess multimorbidity in administrative databases, and about a third are of low to moderate quality. A more consensual approach to the number of diseases or groups of diseases included in multimorbidity measures may improve comparison between regions, and potentially provide better control for multimorbidity-related confounding in studies.

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Perceived Stress, Multimorbidity, and Risk for Hospitalizations for Ambulatory Care–sensitive Conditions

Abstract: Elevated perceived stress levels are associated with increased risk for ACSC-related hospitalization and poor short-term prognosis.

Cited by 14 publications

References 43 publications

Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states

Associations between community well-being and hospitalisation rates: results from a cross-sectional study within six US states

Prevalence of persons contacting general practice for psychological stress in Denmark

Multimorbidity measures from health administrative data using ICD system codes: A systematic review

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