大多数慢性疾病患者患有一种或多种慢性疾病,共病状态在老年人中十分常见(图1和图2)~1。共病状态的重要性在于其与降低生活质量、高死亡率、多重用药、更高药物不良事件几率、更多计划外医疗服务耗费均相关~(2-5)。共病患者需要频繁前往初级医疗保健机构和各个专科就诊,这些机构的医师之 Most patients with chronic diseases have one or more chronic diseases, and comorbid conditions are common in the elderly (Figures 1 and 2). The comorbidity status is important in that it is associated with a reduction in quality of life, high mortality, multiple drug use, a higher incidence of adverse drug events, and more unplanned medical services (2-5). Comorbid patients need frequent visits to primary care and various specialist care, and physicians at these institutions