BACKGROUND Multimorbidity is a growing concern for healthcare systems, with many countries experiencing demographic transition to older population profiles. A simple multisource comorbidity score (MCS) has been recently developed and validated. A very large real-world investigation was conducted with the aim of measuring inequalities in the MCS distribution across Italy. METHODS Beneficiaries of the Italian National Health Service aged 50-85 years who in 2018 were resident in one of the 10 participant regions formed the study population (15.7 million of the 24.9 million overall resident in Italy). MCS was assigned to each beneficiary by categorizing the individual sum of the comorbid values (i.e. the weights corresponding to the comorbid conditions of which the individual suffered) into one of the six categories denoting a progressive worsening comorbidity status. MCS distributions in women and men across geographic partitions were compared. RESULTS Compared with beneficiaries from northern Italy, those from centre and south showed worse comorbidity profile for both women and men. MCS median age (i.e. the age above which half of the beneficiaries suffered at least one comorbidity) ranged from 60 (centre and south) to 68 years (north) in women and from 63 (centre and south) to 68 years (north) in men. The percentage of comorbid population was lower than 50% for northern population, whereas it was around 60% for central and southern ones. CONCLUSION MCS allowed of capturing geographic variability of multimorbidity prevalence, thus showing up its value for addressing health policy in order to guide national health planning.

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通过多源合并症评分衡量意大利的多发病率不平等：一项全国性研究

背景多发病是医疗保健系统日益关注的问题，许多国家正在经历人口结构向老年人口的转变。最近开发并验证了一个简单的多源合并症评分 (MCS)。进行了一项非常大的现实世界调查，目的是衡量意大利各地 MCS 分布的不平等。方法 2018 年居住在 10 个参与地区之一的意大利国民健康服务受益人年龄在 50-85 岁之间，构成了研究人口（意大利总居民 2490 万中的 1570 万）。通过对合并症值的个体总和进行分类，将 MCS 分配给每个受益人（即 权重对应于个人遭受的合并症）归入六个类别之一，表示合并症状态逐渐恶化。比较了跨地理分区的女性和男性的 MCS 分布。结果 与意大利北部的受益人相比，中部和南部的受益人女性和男性的共病情况更差。MCS 中位年龄（即超过一半的受益人至少患有一种合并症的年龄）范围为女性 60（中部和南部）至 68 岁（北部），女性为 63（中部和南部）至 68 岁（北部）男人。北方人群共患病比例低于50%，而中南部人群为60%左右。结论 MCS 允许捕捉多发病率的地理变异性，