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BMC Public Health. 2015 Apr 23;15:415. doi: 10.1186/s12889-015-1733-2.

The increasing burden and complexity of multimorbidity.

Pefoyo AJ1,2,3, Bronskill SE4,5, Gruneir A6,7,8,9, Calzavara A10, Thavorn K11,12,13, Petrosyan Y14, Maxwell CJ15,16, Bai Y17,18, Wodchis WP19,20,21.

Author information

1
Cancer Screening, Cancer Care Ontario/Action Cancer Ontario, 505 University Avenue, Room 18-14, Toronto, M5G 1X3, Ontario, Canada. Anna.Kone@cancercare.on.ca.
2
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Anna.Kone@cancercare.on.ca.
3
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Anna.Kone@cancercare.on.ca.
4
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. susan.bronskill@ices.on.ca.
5
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. susan.bronskill@ices.on.ca.
6
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. gruneir@ualberta.ca.
7
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. gruneir@ualberta.ca.
8
Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. gruneir@ualberta.ca.
9
Department of Family Medicine, University of Alberta, Edmonton, AB, Canada. gruneir@ualberta.ca.
10
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. andrew.calzavara@ices.on.ca.
11
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. kthavorn@ohri.ca.
12
Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada. kthavorn@ohri.ca.
13
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada. kthavorn@ohri.ca.
14
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. yelena.petrosyan@mail.utoronto.ca.
15
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. colleen.maxwell@uwaterloo.ca.
16
Schools of Pharmacy and Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada. colleen.maxwell@uwaterloo.ca.
17
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. yuqing.bai@utoronto.ca.
18
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. yuqing.bai@utoronto.ca.
19
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. walter.wodchis@utoronto.ca.
20
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. walter.wodchis@utoronto.ca.
21
Toronto Rehabilitation Institute, Toronto, ON, Canada. walter.wodchis@utoronto.ca.

Abstract

BACKGROUND:

Multimorbidity, 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.

METHODS:

This 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.

RESULTS:

The 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.

CONCLUSION:

The 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.

PMID:
25903064
PMCID:
PMC4415224
DOI:
10.1186/s12889-015-1733-2
[Indexed for MEDLINE]
Free PMC Article

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