Multimorbidity and comorbidity in the Dutch population – data from general practices

BMC Public Health

Caroline A Baan³  François G Schellevis¹  Robert A Verheij⁴  Christel E van Dijk⁴  Nancy Hoeymans²  Lidwien C Lemmens³  Boukje M van Gelder³  H Susan J Picavet³  Sandra H van Oostrom³ 

[1] Department of General Practice/EMGO Institute, VU University Medical Centre, Amsterdam, the Netherlands;Centre for Public Health Forecasting, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven, 3720 BA, the Netherlands;Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, the Netherlands;Department of General Practice, Netherlands Institute for Health Services Research, P.O. Box 1568, Utrecht, 3500 BN, the Netherlands

关键词: Prevalence;    Epidemiology;    Chronic disease;    Comorbidity;    Multimorbidity;   

Others  :  1163181
DOI  :  10.1186/1471-2458-12-715

 received in 2012-03-05, accepted in 2012-08-10,  发布年份 2012

【 摘 要 】

Background

Multimorbidity is increasingly recognized as a major public health challenge of modern societies. However, knowledge about the size of the population suffering from multimorbidity and the type of multimorbidity is scarce. The objective of this study was to present an overview of the prevalence of multimorbidity and comorbidity of chronic diseases in the Dutch population and to explore disease clustering and common comorbidities.

Methods

We used 7 years data (2002–2008) of a large Dutch representative network of general practices (212,902 patients). Multimorbidity was defined as having two or more out of 29 chronic diseases. The prevalence of multimorbidity was calculated for the total population and by sex and age group. For 10 prevalent diseases among patients of 55 years and older (N = 52,014) logistic regressions analyses were used to study disease clustering and descriptive analyses to explore common comorbid diseases.

Results

Multimorbidity of chronic diseases was found among 13% of the Dutch population and in 37% of those older than 55 years. Among patients over 55 years with a specific chronic disease more than two-thirds also had one or more other chronic diseases. Most disease pairs occurred more frequently than would be expected if diseases had been independent. Comorbidity was not limited to specific combinations of diseases; about 70% of those with a disease had one or more extra chronic diseases recorded which were not included in the top five of most common diseases.

Conclusion

Multimorbidity is common at all ages though increasing with age, with over two-thirds of those with chronic diseases and aged 55 years and older being recorded with multimorbidity. Comorbidity encompassed many different combinations of chronic diseases. Given the ageing population, multimorbidity and its consequences should be taken into account in the organization of care in order to avoid fragmented care, in medical research and healthcare policy.

【 授权许可】

   
2012 van Oostrom et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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