Time Trends in Prevalence of Chronic Diseases and Multimorbidity Not Only due to Aging: Data from General Practices and Health Surveys

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Introduction

Chronic diseases and multimorbidity are common and expected to rise over the coming years. The objective of this study is to examine the time trend in the prevalence of chronic diseases and multimorbidity over the period 2001 till 2011 in the Netherlands, and the extent to which this can be ascribed to the aging of the population.

Methods

Monitoring study, using two data sources: 1) medical records of patients listed in a nationally representative network of general practices over the period 2002–2011, and 2) national health interview surveys over the period 2001–2011. Regression models were used to study trends in the prevalence-rates over time, with and without standardization for age.

Results

An increase from 34.9% to 41.8% (p<0.01) in the prevalence of chronic diseases was observed in the general practice registration over the period 2004–2011 and from 41.0% to 46.6% (p<0.01) based on self-reported diseases over the period 2001–2011. Multimorbidity increased from 12.7% to 16.2% (p<0.01) and from 14.3% to 17.5% (p<0.01), respectively. Aging of the population explained part of these trends: about one-fifth based on general practice data, and one-third for chronic diseases and half of the trend for multimorbidity based on health surveys.

Conclusions

The prevalence of chronic diseases and multimorbidity increased over the period 2001–2011. Aging of the population only explained part of the increase, implying that other factors such as health care and society-related developments are responsible for a substantial part of this rise.

Related collections

Most cited references 12

Record: found
Abstract: found
Article: not found

Gender differences in the utilization of health care services.

K D Bertakis, R Azari, L J Helms … (2000)

Studies have shown that women use more health care services than men. We used important independent variables, such as patient sociodemographics and health status, to investigate gender differences in the use and costs of these services. New adult patients (N = 509) were randomly assigned to primary care physicians at a university medical center. Their use of health care services and associated charges were monitored for 1 year of care. Self-reported health status was measured using the Medical Outcomes Study Short Form-36 (SF-36). We controlled for health status, sociodemographic information, and primary care physician specialty in the statistical analyses. Women had significantly lower self-reported health status and lower mean education and income than men. Women had a significantly higher mean number of visits to their primary care clinic and diagnostic services than men. Mean charges for primary care, specialty care, emergency treatment, diagnostic services, and annual total charges were all significantly higher for women than men; however, there were no differences for mean hospitalizations or hospital charges. After controlling for health status, sociodemographics, and clinic assignment, women still had higher medical charges for all categories of charges except hospitalizations. Women have higher medical care service utilization and higher associated charges than men. Although the appropriateness of these differences was not determined, these findings have implications for health care.

0 comments Cited 383 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Defining chronic conditions for primary care with ICPC-2.

Julie O'Halloran, Helena Britt, Daniel G. Miller (2004)

With the increasing prevalence of chronic conditions, there is need for a standardized definition of chronicity for use in research, to evaluate the population prevalence and general practice management of chronic conditions. Our aims were to determine the characteristics required to define chronicity, apply them to a primary care classification and provide a defined codeset of chronic conditions. A literature review evaluated characteristics used to define chronic conditions. The final set of characteristics was applied to the International Classification of Primary Care-Version 2 (ICPC-2) through more specific terms available in ICPC-2 PLUS, an extended terminology classified to ICPC-2. A set of ICPC-2 rubrics was delineated as representing chronic conditions. Factors found to be relevant to a definition of chronic conditions for research were: duration; prognosis; pattern; and sequelae. Within ICPC-2, 129 rubrics were described as 'chronic', and another 20 rubrics had elements of chronicity. Duration was the criterion most frequently satisfied (98.4% of chronic rubrics), while 88.2% of rubrics met at least three of the four criteria. Monitoring the prevalence and management of chronic conditions is of increasing importance. This study provided evidence for multifaceted definitions of chronicity. While all characteristics examined could be used by those interested in chronicity, the list has been designed to identify chronic conditions managed in Australian general practice, and is therefore not a nomenclature of all chronic conditions. Subsequent analysis of chronic conditions using pre-existing data sets will provide a baseline measure of chronic condition prevalence and management in general practice.

0 comments Cited 137 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Multimorbidity of chronic diseases and health care utilization in general practice

Sandra van Oostrom, H. Susan J. Picavet, Simone R. de Bruin … (2014)

Background Multimorbidity is common among ageing populations and it affects the demand for health services. The objective of this study was to examine the relationship between multimorbidity (i.e. the number of diseases and specific combinations of diseases) and the use of general practice services in the Dutch population of 55 years and older. Methods Data on diagnosed chronic diseases, contacts (including face-to-face consultations, phone contacts, and home visits), drug prescription rates, and referral rates to specialised care were derived from the Netherlands Information Network of General Practice (LINH), limited to patients whose data were available from 2006 to 2008 (N = 32,583). Multimorbidity was defined as having two or more out of 28 chronic diseases. Multilevel analyses adjusted for age, gender, and clustering of patients in general practices were used to assess the association between multimorbidity and service utilization in 2008. Results Patients diagnosed with multiple chronic diseases had on average 18.3 contacts (95% CI 16.8 19.9) per year. This was significantly higher than patients with one chronic disease (11.7 contacts (10.8 12.6)) or without any (6.1 contacts (5.6 6.6)). A higher number of chronic diseases was associated with more contacts, more prescriptions, and more referrals to specialized care. However, the number of contacts per disease decreased with an increasing number of diseases; patients with a single disease had between 9 to 17 contacts a year and patients with five or more diseases had 5 or 6 contacts per disease per year. Contact rates for specific combinations of diseases were lower than what would be expected on the basis of contact rates of the separate diseases. Conclusion Multimorbidity is associated with increased health care utilization in general practice, yet the increase declines per additional disease. Still, with the expected rise in multimorbidity in the coming decades more extensive health resources are required.

0 comments Cited 101 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Alessandra Marengoni: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 2 August 2016

Publication date Collection: 2016

Volume: 11

Issue: 8

Electronic Location Identifier: e0160264

Affiliations

[1 ]Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands

[2 ]Centre for Health and Society, National Institute for Public Health and the Environment, Bilthoven, the Netherlands

[3 ]Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands

[4 ]Department of General Practice and Elderly Care Medicine /EMGO Institute for health and care research, VU University Medical Centre, Amsterdam, the Netherlands

University of Brescia, ITALY

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceptualization: SHO RG IS JCK FGS HSJP NH. Data curation: SHO RG HSJP JCK NH. Formal analysis: SHO RG IS. Methodology: SHO RG IS JCK FGS HSJP NH. Writing - original draft: SHO. Writing - review & editing: RG IS JCK FGS HSJP NH.

* E-mail: Sandra.van.oostrom@ 123456rivm.nl

Article

Publisher ID: PONE-D-15-13697

DOI: 10.1371/journal.pone.0160264

PMC ID: 4970764

PubMed ID: 27482903

SO-VID: 923a2b70-4602-4b1b-917a-ddf3c7cfa038

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 31 March 2015

Date accepted : 16 July 2016

Page count

Figures: 1, Tables: 3, Pages: 14

Funding

Statistical analyses for this study were funded by the Dutch Ministry of Health, Welfare and Sport. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Custom metadata

Data Availability All relevant data for the trend analyses are presented in the paper (Tables 1 and 2). Individual data from the NIVEL Primary Care Database are based on electronic medical records of patients. Current patient privacy regulations do not allow sharing of electronic medical records without an explicit review of the steering committee. Therefore, data from the NIVEL Primary Care Database are available upon request and according to conditions as mentioned on the website: http://www.nivel.nl/en/dossier/nivel-primary-care-database. Contact details for the NIVEL Primary Care Database are mentioned at this website. Data from the health surveys were retrieved from Data Archiving and Networked Services (DANS), after permission from Statistics Netherlands. Data sharing is constrained by privacy regulations, as described in the Statistics Netherlands Act of November 2003. Data sets can be obtained via http://dx.doi.org/10.17026/dans-zrm-7r4z and http://dx.doi.org/10.17026/dans-z93-mj8s after permission of Statistics Netherlands, who can be contacted by email: cvb@ 123456cbs.nl , or phone: +31885707070.

Time Trends in Prevalence of Chronic Diseases and Multimorbidity Not Only due to Aging: Data from General Practices and Health Surveys

Read this article at

Abstract

Introduction

Methods

Results

Conclusions

Related collections

PLOS Climate

Most cited references 12

Gender differences in the utilization of health care services.

Defining chronic conditions for primary care with ICPC-2.

Multimorbidity of chronic diseases and health care utilization in general practice

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Page count

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 365

Cited by 118

Most referenced authors 202