A novel comorbidity index in Italy based on diseases detected by the surveillance system PASSI and the Global Burden of Diseases disability weights.

Comorbidity Disability weights Global burden of disease project Health-statistics Surveillance system PASSI

Journal

Population health metrics
ISSN: 1478-7954
Titre abrégé: Popul Health Metr
Pays: England
ID NLM: 101178411

Informations de publication

Date de publication:
30 Oct 2023
Historique:
received: 09 05 2023
accepted: 16 10 2023
medline: 1 11 2023
pubmed: 31 10 2023
entrez: 31 10 2023
Statut: epublish

Résumé

Understanding comorbidity and its burden characteristics is essential for policymakers and healthcare providers to allocate resources accordingly. However, several definitions of comorbidity burden can be found in the literature. The main reason for these differences lies in the available information about the analyzed diseases (i.e., the target population studied), how to define the burden of diseases, and how to aggregate the occurrence of the detected health conditions. In this manuscript, we focus on data from the Italian surveillance system PASSI, proposing an index of comorbidity burden based on the disability weights from the Global Burden of Disease (GBD) project. We then analyzed the co-presence of ten non-communicable diseases, weighting their burden thanks to the GBD disability weights extracted by a multi-step procedure. The first step selects a set of GBD weights for each disease detected in PASSI using text mining. The second step utilizes an additional variable from PASSI (i.e., the perceived health variable) to associate a single disability weight for each disease detected in PASSI. Finally, the disability weights are combined to form the comorbidity burden index using three approaches common in the literature. The comorbidity index (i.e., combined disability weights) proposed allows an exploration of the magnitude of the comorbidity burden in several Italian sub-populations characterized by different socioeconomic characteristics. Thanks to that, we noted that the level of comorbidity burden is greater in the sub-population characterized by low educational qualifications and economic difficulties than in the rich sub-population characterized by a high level of education. In addition, we found no substantial differences in terms of predictive values of comorbidity burden adopting different approaches in combining the disability weights (i.e., additive, maximum, and multiplicative approaches), making the Italian comorbidity index proposed quite robust and general.

Sections du résumé

BACKGROUND BACKGROUND
Understanding comorbidity and its burden characteristics is essential for policymakers and healthcare providers to allocate resources accordingly. However, several definitions of comorbidity burden can be found in the literature. The main reason for these differences lies in the available information about the analyzed diseases (i.e., the target population studied), how to define the burden of diseases, and how to aggregate the occurrence of the detected health conditions.
METHODS METHODS
In this manuscript, we focus on data from the Italian surveillance system PASSI, proposing an index of comorbidity burden based on the disability weights from the Global Burden of Disease (GBD) project. We then analyzed the co-presence of ten non-communicable diseases, weighting their burden thanks to the GBD disability weights extracted by a multi-step procedure. The first step selects a set of GBD weights for each disease detected in PASSI using text mining. The second step utilizes an additional variable from PASSI (i.e., the perceived health variable) to associate a single disability weight for each disease detected in PASSI. Finally, the disability weights are combined to form the comorbidity burden index using three approaches common in the literature.
RESULTS RESULTS
The comorbidity index (i.e., combined disability weights) proposed allows an exploration of the magnitude of the comorbidity burden in several Italian sub-populations characterized by different socioeconomic characteristics. Thanks to that, we noted that the level of comorbidity burden is greater in the sub-population characterized by low educational qualifications and economic difficulties than in the rich sub-population characterized by a high level of education. In addition, we found no substantial differences in terms of predictive values of comorbidity burden adopting different approaches in combining the disability weights (i.e., additive, maximum, and multiplicative approaches), making the Italian comorbidity index proposed quite robust and general.

Identifiants

pubmed: 37904213
doi: 10.1186/s12963-023-00317-7
pii: 10.1186/s12963-023-00317-7
pmc: PMC10617130
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

18

Subventions

Organisme : Università Ca' Foscari di Venezia
ID : PON 2014-2020/DM 1062
Organisme : Università Ca' Foscari Venezia
ID : PRIN-MIUR project n. 20177BR-JXS

Informations de copyright

© 2023. The Author(s).

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Auteurs

Angela Andreella (A)

Department of Economics, Ca' Foscari University of Venice, Venice, Italy. angela.andreella@unive.it.

Lorenzo Monasta (L)

Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.

Stefano Campostrini (S)

Department of Economics, Ca' Foscari University of Venice, Venice, Italy.

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