BACKGROUND There is broad consensus that countries need to develop and implement person-centred integrated care to better meet the needs of their growing populations with multimorbidity. To develop appropriate care, it is essential to know the needs for care and support among these populations. For this purpose, we examined whether subgroups of people with multimorbidity could be distinguished based on their needs, and profiled these subgroups according to medical complexity and the availability of personal resources. METHODS Persons diagnosed with two or more somatic chronic diseases (N = 613) were selected from 38 general practices throughout the Netherlands. We conducted a cluster analysis of their scores on the RAND-36 questionnaire of health-related quality of life (QoL), to gain insight in their needs for care and support. Differences in demographics, medical characteristics and personal resources between the identified clusters were tested using analysis of variance and chi-square tests. RESULTS The cluster analysis revealed three subgroups: 1. a group with a relatively good QoL (48% of the sample), 2. a group with a poor physical QoL (28%), and 3. a group with a poor QoL in all domains assessed by the RAND-36 (24%). The group with a relatively good QoL had more favourable medical characteristics than the other groups, i.e., less chronic diseases, shorter illness duration, more stable course of illness, better controllable conditions, less polypharmacy. The group with a poor QoL in all domains could rely on less personal resources (education, income, social support, health literacy, self-management capabilities) than the other groups. CONCLUSIONS Different subgroups of people with multimorbidity can be distinguished based on their needs for care and support. These needs are not only determined by demographic and medical characteristics, but also by the personal resources people have available to manage their health and care. Patient profiles combining medical complexity and personal resources could guide the development of integrated care for specific target groups of persons with multimorbidity.

中文翻译：

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根据他们的护理和支持需求，确定多病患者的亚组。

背景技术广泛共识是，各国需要发展和实施以人为本的综合护理，以更好地满足其多发病率不断增长的人口的需求。为了发展适当的护理，了解这些人群对护理和支持的需求至关重要。为此，我们检查了是否可以根据需要区分多发病人群亚组，并根据医疗复杂性和个人资源的可用性对这些亚组进行了概述。方法从整个荷兰的38种常规实践中选择被诊断患有两种或多种躯体慢性疾病（N = 613）的患者。我们在RAND-36健康相关生活质量（QoL）调查问卷中对他们的分数进行了聚类分析，以了解他们的护理和支持需求。使用方差分析和卡方检验来检验所识别集群之间的人口统计学，医学特征和个人资源差异。结果聚类分析显示了三个亚组：1.一组具有相对较好的QoL（占样本的48％），2。一组具有较差的QoL（占28％）和3.一个组的QoL均较差RAND-36评估的域名（24％）。QoL相对较好的组比其他组具有更好的医学特征，即，慢性病更少，病程更短，病程更稳定，病情可控制，多药店更少。与其他群体相比，在所有领域中生活质量较差的群体所依赖的个人资源（教育，收入，社会支持，健康素养，自我管理能力）都更少。结论可以根据他们对护理和支持的需求来区分多发病的不同亚组。这些需求不仅取决于人口和医学特征，还取决于人们可用来管理其健康和护理的个人资源。结合医疗复杂性和个人资源的患者资料可以指导针对特定目标人群的多种疾病的综合治疗的发展。