Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Aug 30:12:715.
doi: 10.1186/1471-2458-12-715.

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

Sandra H van Oostrom  1 , H Susan J Picavet, Boukje M van Gelder, Lidwien C Lemmens, Nancy Hoeymans, Christel E van Dijk, Robert A Verheij, François G Schellevis, Caroline A Baan
Affiliations

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

Sandra H van Oostrom et al. BMC Public Health. .

Abstract

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Prevalence of 10 chronic diseases and comorbidity (%) among patients of 55 years and older.
See this image and copyright information in PMC

References

    1. Fortin M, Soubhi H, Hudon C, Bayliss EA, van den Akker M. Multimorbidity's many challenges. BMJ. 2007;334(7602):1016–1017. doi: 10.1136/bmj.39201.463819.2C. - DOI - PMC - PubMed
    1. Mercer SW, Smith SM, Wyke S, O'Dowd T, Watt GC. Multimorbidity in primary care: developing the research agenda. Fam Pract. 2009;26(2):79–80. doi: 10.1093/fampra/cmp020. - DOI - PubMed
    1. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3(3):223–228. doi: 10.1370/afm.272. - DOI - PMC - PubMed
    1. Laux G, Kuehlein T, Rosemann T, Szecsenyi J. Co- and multimorbidity patterns in primary care based on episodes of care: results from the German CONTENT project. BMC Health Serv Res. 2008;8:14. doi: 10.1186/1472-6963-8-14. - DOI - PMC - PubMed
    1. van den Akker M, Buntinx F, Metsemakers JF, Roos S, Knottnerus JA. Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol. 1998;51(5):367–375. doi: 10.1016/S0895-4356(97)00306-5. - DOI - PubMed