基于社区共病网络的江苏省慢性非传染性疾病共病现状分析与防治策略研究

Prevalence and Control Multimorbidity of Non-communicable Chronic Diseases in the Communities in Jiangsu Province Based on Network Analysis

目的:分析社区慢性非传染性疾病共病类型、组合、共患率和聚集性,评价社区慢性非传染性疾病共病模式。方法:利用2013年和2018年慢性非传染性疾病患者家庭入户调查数据,采用Pajek软件分析社区共病网络。结果:慢性非传染性疾病人群共病患病率为22.11% (2013年)和26.47% (2018年),其中以3种慢性非传染性疾病和4种慢性非传染性疾病共患病最为常见;高血压、糖尿病、肥胖、冠心病、脑血管病在社区共病网络出现频次最多,其中最常见的共患病对是高血压和糖尿病、高血压和肥胖、糖尿病和肥胖;最常见的10种慢性非传染性疾病,其共病组合类型由37种增加至42种,网络密度由0.74上升至0.84,集聚系数由0.90上升至0.95。结论:慢性非传染性疾病共患率有所下降,但慢性非传染性疾病共病组合形式趋于复杂;肥胖和脑血管类疾病是当前社区共病网络的重点疾病;社区应当基于此类重点疾病的可控风险因素和不可控风险因素采取针对性防治策略,提升慢性非传染性疾病共病群体预防的效率。

Objective:To describe the model of multimorbidity through evaluating the type,combination,prevalence and clustering coefficient of multiple non-communicable chronic diseases in the communities.Methods:Using the individual data from two rounds of household survey in 2013 and 2018,Pajek software was adopted to measure the network of multimorbidity in the communities.Results:The prevalence of multimorbidity was 22.11% in 2013 and 26.47% in 2018,respectively.It was the most common that 3 or 4 chronic conditions coexisted in the patients with multimorbidity.Hypertension,diabetes,obesity,coronary heart disease and cerebrovascular disease were the top five diseases in the multimorbidity network in the communities.Multimorbidity with hypertension and diabetes,hypertension and obesity,diabetes and obesity,were the common coexisting diseases.With regard to the network,the line increased from 37 in 2013 to 42 in 2018,and the density increased from 0.74 to 0.84,and clustering coefficient increased from 0.90 to0.95.Conclusion:The prevalence of multimorbidity was reduced but the complexity tended to be increased.Obesity and cerebrovascular disease were the key targets in the multimorbidity network.In order to improve the cost effectiveness,strategies for multimorbidity control and prevention should be developed on targeting key diseases in the multimorbidity network.