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The use of comorbidities among adults experiencing care transitions: a systematic review and evolutionary analysis of empirical literature.

Publication ,  Journal Article
Buck, HG; Meghani, S; Bettger, JP; Byun, E; Fachko, MJ; O'Connor, M; Tocchi, C; Naylor, M
Published in: Chronic Illn
December 2012

OBJECTIVE: To systematically review how comorbidities are employed in the empirical literature for adults coping with multiple chronic conditions during common episodes of acute illness that resulted in transition across health care setting. METHODS: Evolutionary concept analysis inductively identifies current consensus regarding the usage of a concept and results in exploring attributes and clarification of the concept. Sixty studies from 1965 to 2009 identified from MEDLINE, CINAHL, PsychINFO, and ISI Web of Science databases were analysed. RESULTS: Comorbidities were used heterogeneously among reviewed studies with most controlling for their presence (n=33) and lacking robust measurement (n=37). The designation of index or principal condition was equally heterogeneous with approximately half (n=26) representing the main disease or diagnosis of interest to the researcher. In this study comorbidities were associated with personal, disease or system level antecedents and consequences. A conceptual framework is proposed. DISCUSSION: The impact of comorbidities on the care and outcomes of adults coping with multiple chronic conditions is limited by heterogeneous and ambiguous usage. While analytic techniques have become more sophisticated, continued lack of meaningful conceptualization and instrument use has limited maturation of this important concept for research, practice and policy purposes.

Duke Scholars

Published In

Chronic Illn

DOI

EISSN

1745-9206

Publication Date

December 2012

Volume

8

Issue

4

Start / End Page

278 / 295

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Public Health
  • Humans
  • Delivery of Health Care
  • Comorbidity
  • Chronic Disease
  • Adult
  • 4206 Public health
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
 

Citation

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Chicago
ICMJE
MLA
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Buck, H. G., Meghani, S., Bettger, J. P., Byun, E., Fachko, M. J., O’Connor, M., … Naylor, M. (2012). The use of comorbidities among adults experiencing care transitions: a systematic review and evolutionary analysis of empirical literature. Chronic Illn, 8(4), 278–295. https://doi.org/10.1177/1742395312444741
Buck, Harleah G., Salimah Meghani, Janet Prvu Bettger, Eeeseung Byun, Michael J. Fachko, Melissa O’Connor, Christine Tocchi, and Mary Naylor. “The use of comorbidities among adults experiencing care transitions: a systematic review and evolutionary analysis of empirical literature.Chronic Illn 8, no. 4 (December 2012): 278–95. https://doi.org/10.1177/1742395312444741.
Buck HG, Meghani S, Bettger JP, Byun E, Fachko MJ, O’Connor M, et al. The use of comorbidities among adults experiencing care transitions: a systematic review and evolutionary analysis of empirical literature. Chronic Illn. 2012 Dec;8(4):278–95.
Buck, Harleah G., et al. “The use of comorbidities among adults experiencing care transitions: a systematic review and evolutionary analysis of empirical literature.Chronic Illn, vol. 8, no. 4, Dec. 2012, pp. 278–95. Pubmed, doi:10.1177/1742395312444741.
Buck HG, Meghani S, Bettger JP, Byun E, Fachko MJ, O’Connor M, Tocchi C, Naylor M. The use of comorbidities among adults experiencing care transitions: a systematic review and evolutionary analysis of empirical literature. Chronic Illn. 2012 Dec;8(4):278–295.
Journal cover image

Published In

Chronic Illn

DOI

EISSN

1745-9206

Publication Date

December 2012

Volume

8

Issue

4

Start / End Page

278 / 295

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Public Health
  • Humans
  • Delivery of Health Care
  • Comorbidity
  • Chronic Disease
  • Adult
  • 4206 Public health
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services