Multimorbidity in the German Elderly Population – Part 1: Prevalence in Ambulatory Medical Care
Eine Analyse auf der Basis von Abrechnungsdaten der Gesetzlichen Krankenversicherunggerman translation / full article
A Study Based on Statutory Health Insurance Data
Background: The authors report the results of cross-sectional studies on the prevalence of multimorbidity in Germany, the underlying disease combinations and the utilization patterns of ambulatory medical care in the elderly German statutory insured population.
Methods: The study is based on the claims data of all policy holders aged 65 and older of a statutory health insurance company in 2004 (n = 123,224). Adjustment for age and gender was performed for the German population of December 31, 2004. A person was defined as multimorbid if she/he had at least three diagnoses out of a list of 46 chronic conditions based on ICD 10 diagnoses in three or more quarters within the one-year observation period.
Results: 62 % of the sample was multimorbid. Out of the possible 15,180 combinations of three chronic conditions, 15,024 (99 %) were found in the database. Triads of the six most prevalent individual chronic conditions (hypertension, dyslipidemia, chronic low back pain, diabetes mellitus, osteoarthritis and ischemic heart disease) span the disease spectrum of 42 % of the multimorbid sample. Gender differences were minor.
Conclusion: The above list of dominating chronic conditions and their combinations could present a pragmatic start for the development of needed guidelines related to multimorbidity.