BackgroundIncreased life expectancy in Western societies does not necessarily mean better quality of life. To improve resources management, management systems have been set up in health systems to stratify patients according to morbidity, such as Clinical Risk Groups (CRG). The main objective of this study was to evaluate the effect of multimorbidity on health-related quality of life (HRQL) in primary care.MethodsAn observational cross-sectional study, based on a representative random sample (n = 306) of adults from a health district (N = 32,667) in east Spain (Valencian Community), was conducted in 2013. Multimorbidity was measured by stratifying the population with the CRG system into nine mean health statuses (MHS). HRQL was assessed by EQ-5D dimensions and the EQ Visual Analogue Scale (EQ VAS). The effect of the CRG system, age and gender on the utility value and VAS was analysed by multiple linear regression. A predictive analysis was run by binary logistic regression with all the sample groups classified according to the CRG system into the five HRQL dimensions by taking the “healthy” group as a reference. Multivariate logistic regression studied the joint influence of the nine CRG system MHS, age and gender on the five EQ-5D dimensions.ResultsOf the 306 subjects, 165 were female (mean age of 53). The most affected dimension was pain/discomfort (53%), followed by anxiety/depression (42%). The EQ-5D utility value and EQ VAS progressively lowered for the MHS with higher morbidity, except for MHS 6, more affected in the five dimensions, save self-care, which exceeded MHS 7 patients who were older, and MHS 8 and 9 patients, whose condition was more serious. The CRG system alone was the variable that best explained health problems in HRQL with 17%, which rose to 21% when associated with female gender. Age explained only 4%.ConclusionsThis work demonstrates that the multimorbidity groups obtained by the CRG classification system can be used as an overall indicator of HRQL. These utility values can be employed for health policy decisions based on cost-effectiveness to estimate incremental quality-adjusted life years (QALY) with routinely e-health data.Patients under 65 years with multimorbidity perceived worse HRQL than older patients or disease severity. Knowledge of multimorbidity with a stronger impact can help primary healthcare doctors to pay attention to these population groups.

Objectives: The study expects to combined with community pharmacies, schools and pharmaceutical service, with the health resources of local communities to provide a wide range of pharmaceutical care services, to evaluate the effectiveness of cognition and behavior and strengthen the safety of correct medication in community. MethOds: This research from March to November 2015, Based on "five core abilities in correct medication in over-the-counter cold medicine articles", and to evaluates the effectiveness by"The questionnaire of knowledge and ability of correct medication".The method undergoes a pre-test before the survey, accompanied by a post-test during the survey and a post -post-test 3 months after the survey. The outcomes are compared with one another and analyzed. Results: It is estimated that 2,827 people have participated, 40 hygiene education lectures being held. At the pre-test before health education the average correct ratio is 41% and after health education the average correct ratio for post -test in medication knowledge accounts is 89%, After 3 months, the average correct ratio for post-post-test is 73%. The health education gains widely recognition from people in correct medication , with a nearly 90-percent satisfaction rate for lecturers and their topics. cOnclusiOns: There is an obvious increase to raise community people's awareness of correct medication and health knowledge after the process strategies and medication conducts provided by pharmacists visiting communities. On top of that, correct concepts of medication permeate people, widen the scope of service and scrutiny for medication safety, and decrease the waste of health care and medical resources.Objectives: Precautionary medical check-ups have proven to be an essential tool in colorectal cancer (CRC) prevention, which is due to the long, asymptomatic carcinogenesis of CRC. This research aims at evaluating the market-leading screening methods, the colonoscopy (COLO), the sigmoidoscopy (SIGM), the flexible occult blood test (FOBT) and the DNA-Test (DNA), and examining the effect of cancercausing risk factor on the patient's prognosis. MethOds: A cost-effectivenessanalysis of the leading screening methods in the Austrian population in the 50+ age group was performed. Therefore an agent-based simulation model of the colorectal cancer prevention in Austria was developed. Natural development and progression of CRC including the influence of risk factors like smoking, drinking and gender were analysed to consider an indirect method of interference. Through scenario calculation and system analysis various parameter settings and possible situations were calculated as an instrument for future planning in the Austrian health care system. Besides the alternative options to the current national screening programme, also the possibility of an indirect preventive measure, the introduction of an organized invitation procedure and the adjustment of screening recommendations were examined. Results: COLO and SIGM turned out to be the most cost-effective...