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Previous issue date: 2017-05-15 === A presen?a simult?nea de duas ou mais doen?as ou condi??es cr?nicas em um indiv?duo denomina-se multimorbidade. Conhecer a ocorr?ncia desta condi??o na popula??o ? relevante e tem sido objeto de estudo nos ?ltimos anos, uma vez que impacta na qualidade de vida da popula??o, al?m de ampliar a utiliza??o e os gastos dos servi?os de sa?de. Este estudo teve como base os dados da Pesquisa Nacional de Sa?de, inqu?rito domiciliar realizado no Brasil no ano de 2013 e teve como objetivo avaliar o perfil de multimorbidade da popula??o brasileira (?18 anos) e suas rela??es com vari?veis socioecon?micas, demogr?ficas, relacionadas ao estilo de vida e de uso de servi?os de sa?de. Foram inclu?dos dados de 60.202 participantes. Foi realizada uma an?lise descritiva para estimar as preval?ncias (%) de multimorbidade considerando um n?vel de confian?a de 95%. Para observar a rela??o entre a presen?a de multimorbidade e as vari?veis independentes realizou-se a an?lise multivariada mediante regress?o de Poisson com vari?ncia robusta. Para observar as combina??es entre as doen?as cr?nicas foi realizada uma an?lise de clusters. Os resultados mostram um contingente populacional consider?vel de pessoas com duas ou mais doen?as cr?nicas no Brasil. A preval?ncia de multimorbidade foi de 23,6% e foi maior entre mulheres (RP=1,46), pessoas da faixa et?ria de 60 anos ou mais (RP=6,44) , entre os que possuem planos privados de sa?de (RP= 1,19) e que n?o possuem ocupa??o (RP= 1,21). Observou-se tamb?m uma maior preval?ncia entre indiv?duos ex-fumantes (RP=1,38) e nas pessoas com obesidade (RP=1,74). O uso de servi?os de sa?de nos ?ltimos 12 meses foi significativamente maior para os indiv?duos com multimorbidade, entre os que realizaram consultas m?dicas (RP= 1,31), nos que tiveram interna??es (RP=2,12) e nos que tiveram atendimentos de urg?ncia e emerg?ncia em domic?lios (RP=3,75). A combina??o de doen?as cr?nicas mais frequente foi a hipertens?o com a hipercolesterolemia (7,2%). Na an?lise de conglomerados quatro clusters de doen?as foram identificados. Os padr?es de agrupamentos mais prevalentes tamb?m foram associados a fatores socioecon?micos, demogr?ficos e relacionados ao estilo de vida. O sexo feminino, o tabagismo e a obesidade foram fatores de risco comum a todos os clusters. A preval?ncia de multimorbidade da popula??o brasileira variou de acordo com fatores socioecon?micos, demogr?ficos, relacionados ao estilo de vida e tamb?m aumentou o uso servi?os de sa?de,e devem ser considerados no planejamento de servi?os de sa?de e desenvolvimento de estrat?gias de preven??o e tratamento das m?ltiplas doen?as ou condi??es cr?nicas. === The simultaneous occurrence of two or more chronic diseases in a person is called multimorbidity. Knowing the occurrence of this condition in the population has been the subject of researches in recent years, since it impacts on the quality of life of the population, in addition to expanding the use and spending of health services. This study was based on data from the National Health Survey, a household survey conducted in Brazil in the year 2013 and the objective was to evaluate the multimorbidity profile of the Brazilian population (?18 years) and its relations with socioeconomic, demographic, related to lifestyle variables and health services utilization. Data from 60,202 participants were included. A descriptive analysis was performed to estimate the prevalence (%) of multimorbidity considering a 95% confidence level. In order to observe the relationship between the presence of multimorbidity and the independents variables, the multivariate analysis was performed using Poisson regression with robust variance. To observe the combinations between chronic conditions, a cluster analysis was performed. The results show a considerable number of people with two or more chronic diseases in Brazil. The prevalence of multimorbity was 23.6% and was higher among women (PR = 1.46), people aged 60 years or older (PR = 6.44), among those with private health plans (PR = 1.19) and that they do not have occupation (PR = 1.21). It was also observed a higher prevalence among ex-smokers (PR = 1.38) and in those with obesity (PR = 1.74). The use of health services in the last 12 months was significantly higher for individuals with multimorbidity, among those who had medical appointments (PR = 1.31), those who had hospitalizations (PR = 2.12), and those who had Urgency and emergency at home (PR = 3.75). The most frequent combination of chronic conditions was hypertension with hypercholesterolemia (7.2%). In the conglomerate analysis four clusters of diseases were identified. The most prevalent cluster patterns were also associated with socioeconomic, demographic, and related to lifestyle variables. Female sex, smoking and obesity were common risk factors for all clusters. The prevalence of multimorbidity of the Brazilian population varied according to socioeconomic, demographic and related to lifestyle factors and also increased the use of health services, and should be considered in the planning of health services and development of strategies for prevention and treatment of multiple chronic diseases.
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