Health care utilization of patients with multiple chronic diseases in the Netherlands: Differences and underlying factors

作者：Hopman Petra; Heins Marianne J; Korevaar Joke C; Rijken Mieke; Schellevis Francois G^*

来源：European Journal of Internal Medicine, 2016, 35: 44-50.

DOI：10.1016/j.ejim.2016.08.025

• Multimorbidity
• Chronic disease
• Health care utilization
• Epidemiology

Purpose: To examine health care utilization of people with multiple chronic diseases in The Netherlands compared to people with a single chronic disease, and to identify subgroups of multimorbid patients according to health care utilization.
Methods: All patients diagnosed with one or more chronic diseases in 2008-2009 (N = 54,051) were selected from the nationwide NIVEL Primary Care Database, and data on their GP contacts and medication in 2010 were retrieved. Data on hospital admissions, household size and income were added. Chi-square-tests and multivariate regression analyses were performed to analyze differences betweenmultimorbid patients and patients with a single chronic disease, and between subgroups of multimorbid patients derived from cluster analysis.
Results: Multimorbid patients (37% of all patients) had more GP contacts, prescribed medications, and hospital admissions (all p <.0001) than patients with a single chronic disease. The largest cluster ofmultimorbid patients (57%) had a relatively low level of health care utilization, a smaller cluster (36%) had higher levels of health care utilization, and 7.6% of patients were heavy health care users (p <.0001 for all variables). The latter were older, more often female, had a lower income, lived in a smaller household, had more chronic diseases, andmore often had specific chronic diseases such as COPD, diabetes and heart failure.
Conclusions: The majority of multimorbid patients have only slightly higher health care utilization than patients with a single chronic disease. Extensive health care utilization among multimorbid patients seems to be related to patient characteristics as well as chronic disease numbers and patterns.

• 出版日期2016-11