{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T23:22:50Z","timestamp":1765840970892,"version":"3.48.0"},"reference-count":17,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003524","name":"Ministry of Business Innovation and Employment","doi-asserted-by":"crossref","award":["UOAX1901"],"award-info":[{"award-number":["UOAX1901"]}],"id":[{"id":"10.13039\/501100003524","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,19]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examines national patterns of functional impairment, and how they vary by the presence of non-communicable disease (NCD), type of health condition, comorbidity, age, sex, ethnicity, deprivation and living situation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional examination using a national research database of linked administrative and survey data sets including census, tax and health data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Aotearoa New Zealand<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All individuals living in NZ on 30 June 2018, identified by the Statistics NZ Integrated Data Infrastructure estimated residential population (4.79 million individuals). Nine NCDs among these individuals were identified from national health data sets using existing and adapted algorithms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Functional impairment was assessed via hospitalisations, comorbidities (Elixhauser index), activity limitations (census) and income support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three-tenths (29%) of the population had at least one NCD. Functional impairment was strongly patterned by NCD prevalence (3% activity limitation in people without any NCDs, 13% if one or more NCDs and 25% if two or more NCDs). Activity limitation was most common in individuals with dementia (68% activity limitation), stroke (42%) and coronary heart disease (26%). After age stratification, there was also a high level of activity limitation and income support in people with mental health conditions. M\u0101ori and Pacific peoples and people living in deprived areas or alone were more likely to have functional impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Functional impairment was strongly patterned by NCD type. NCD prevention efforts and disability supports are needed to reduce the burden of disability experienced.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-079412","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T07:50:20Z","timestamp":1735199420000},"page":"e079412","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["How does the level of functional impairment vary in individuals with non-communicable disease and comorbidity? Cross-sectional analysis of linked census and administrative data in Aotearoa New Zealand"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6116-3941","authenticated-orcid":false,"given":"Andrea M","family":"Teng","sequence":"first","affiliation":[{"name":"Department of Public Health, University of Otago Wellington, Wellington, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Underwood","sequence":"additional","affiliation":[{"name":"University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Bowden","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health and Children\u2019s Health, University of Otago, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamish","family":"Jamieson","sequence":"additional","affiliation":[{"name":"Medicine, University of Otago, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry","family":"Milne","sequence":"additional","affiliation":[{"name":"University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"2025121515205753000_14.12.e079412.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"2025121515205753000_14.12.e079412.2","doi-asserted-by":"publisher","DOI":"10.1186\/s12963-017-0135-3"},{"key":"2025121515205753000_14.12.e079412.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002716","article-title":"Health system costs for individual and comorbid noncommunicable diseases: An analysis of publicly funded health events from New Zealand","volume":"16","author":"Blakely","year":"2019","journal-title":"PLoS Med"},{"key":"2025121515205753000_14.12.e079412.4","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21342"},{"key":"2025121515205753000_14.12.e079412.5","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/XEB.0000000000000138","article-title":"The prevalence of disability among people with cancer, cardiovascular disease, chronic respiratory disease and\/or diabetes: a systematic review","volume":"16","author":"Lisy","year":"2018","journal-title":"Int J Evid Based Healthc"},{"key":"2025121515205753000_14.12.e079412.6","doi-asserted-by":"publisher","DOI":"10.1002\/j.2051-5545.2009.tb00219.x"},{"key":"2025121515205753000_14.12.e079412.7","unstructured":"Dixon S . The employment and income effects of eight chronic and acute health conditions. New Zealand Treasury, 2015."},{"key":"2025121515205753000_14.12.e079412.8","first-page":"20","article-title":"Long-term health conditions among household families in Aotearoa New Zealand: cross-sectional analysis of integrated Census and administrative data","volume":"137","author":"Underwood","year":"2024","journal-title":"N Z Med J"},{"key":"2025121515205753000_14.12.e079412.9","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz014"},{"key":"2025121515205753000_14.12.e079412.10","unstructured":"Statistics New Zealand . Statistical. Methods, September 2021 refresh. Integrated data infrastructure (IDI) refresh: linking report. 2021.1\u201312."},{"key":"2025121515205753000_14.12.e079412.11","unstructured":"Gibb S , Bycroft C , Matheson-Dunning N . Identifying the New Zealand resident population in the integrated data infrastructure (IDI). New Zealand: Census Transformation Statistics, 2016. Available: www.stats.govt.nz"},{"key":"2025121515205753000_14.12.e079412.12","unstructured":"Statistics New Zealand . Linking 2018 census respondents to the integrated data infrastructure. 2019. Available: www.stats.govt.nz"},{"key":"2025121515205753000_14.12.e079412.13","unstructured":"Atkinson J , Salmond C , Crampton P . NZDep2018 index of deprivation: final research report, December 2020. Wellington University of Otago."},{"key":"2025121515205753000_14.12.e079412.14","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/ajag.12790","article-title":"Prevalence and geographical variation of dementia in New Zealand from 2012 to 2015: Brief report utilising routinely collected data within the Integrated Data Infrastructure","volume":"39","author":"Walesby","year":"2020","journal-title":"Australas J Ageing"},{"key":"2025121515205753000_14.12.e079412.15","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.33448","article-title":"Longitudinal Associations of Mental Disorders With Physical Diseases and Mortality Among 2.3 Million New Zealand Citizens","volume":"4","author":"Richmond-Rakerd","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2025121515205753000_14.12.e079412.16","doi-asserted-by":"crossref","unstructured":"Bowden N , Gibb S , Thabrew H , et al . Case identification of mental health and related problems in children and young people using the New Zealand Integrated Data Infrastructure. BMC Med Inform Decis Mak 2020;20. doi:10.1186\/s12911-020-1057-8","DOI":"10.1186\/s12911-020-1057-8"},{"key":"2025121515205753000_14.12.e079412.17","unstructured":"Black A . The IDI prototype spines creation and coverage. Working paper no 16-03. Statistics New Zealand, Available: www.stats.govt.nz"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-079412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T23:21:04Z","timestamp":1765840864000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-079412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":17,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,26]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bmjopen-2023-079412"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-079412","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}