The increasing burden and complexity of multimorbidity

BMC Public Health

Research Article

Anna J Koné Pefoyo¹  Andrew Calzavara²  Kednapa Thavorn³  Colleen J Maxwell⁴  Yelena Petrosyan⁵  YuQing Bai⁶  Susan E Bronskill⁶  Walter P Wodchis⁷  Andrea Gruneir⁸ 

[1] Cancer Screening, Cancer Care Ontario/Action Cancer Ontario, 505 University Avenue, Room 18-14, M5G 1X3, Toronto, Ontario, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada;Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada;Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada;School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada;Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;Schools of Pharmacy and Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada;Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada;Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;Toronto Rehabilitation Institute, Toronto, ON, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada;Institute for Clinical Evaluative Sciences, Toronto, ON, Canada;Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada;Department of Family Medicine, University of Alberta, Edmonton, AB, Canada;

关键词: Multimorbidity;    Chronic conditions;    Prevalence;    Disease clusters;    Age;    Administrative health data;    Ontario;   

DOI  :  10.1186/s12889-015-1733-2

 received in 2015-01-07, accepted in 2015-04-02,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundMultimorbidity, the co-occurrence of two or more chronic conditions, is common among older adults and is known to be associated with high costs and gaps in quality of care. Population-based estimates of multimorbidity are not readily available, which makes future planning a challenge. We aimed to estimate the population-based prevalence and trends of multimorbidity in Ontario, Canada and to examine patterns in the co-occurrence of chronic conditions.MethodsThis retrospective cohort study includes all Ontarians (aged 0 to 105 years) with at least one of 16 common chronic conditions. Descriptive statistics were used to examine and compare the prevalence of multimorbidity by age and number of conditions in 2003 and 2009. The co-occurrence of chronic conditions among individuals with multimorbidity was also explored.ResultsThe prevalence of multimorbidity among Ontarians rose from 17.4% in 2003 to 24.3% in 2009, a 40% increase. This increase over time was evident across all age groups. Within individual chronic conditions, multimorbidity rates ranged from 44% to 99%. Remarkably, there were no dominant patterns of co-occurring conditions.ConclusionThe high prevalence of multimorbidity and numerous combinations of conditions suggests that single, disease-oriented management programs may be less effective or efficient tools for high quality care compared to person-centered approaches.

【 授权许可】

Unknown   
© Kone Pefoyo et al.; licensee Biomed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.