Multiple chronic conditions among US adults who visited physician offices: data from the National Ambulatory Medical Care Survey, 2009

Abstract

Most research on adults with chronic conditions focuses on a single disease or condition, such as hypertension or diabetes, rather than on multiple chronic conditions (MCC). Our study's objective was to compare physician office visits by adults with MCC with visits by adults without MCC, by selected patient demographic characteristics. We also identified the most prevalent dyads and triads of chronic conditions among these patients. We used the National Ambulatory Medical Care Survey, a nationally representative survey of office visits to nonfederal physicians and used 13 of the 20 conditions defined by the National Strategic Framework on Multiple Chronic Conditions. Descriptive estimates were generated and significant differences were tested. In 2009, an estimated 326 million physician office visits, were made by adults aged 18 years or older with MCC representing 37.6% of all medical office visits by adults. Hypertension was the most prevalent chronic condition that appeared in the top 5 MCC dyads and triads, by sex and age groups. The number of visits by patients with MCC increased with age and was greater for men than for women and for adults with public rather than private insurance. Physicians were more likely to prescribe medications at office visits made by patients with MCC. Physician office visits by adults with MCC were not evenly distributed by demographic characteristics.

Figure

Physician office visits made by patients with or without chronic conditions, by number of medications ordered or prescribed. Shows percentage of office-based ambulatory care visits in which 0 through 8 or more medications were ordered or prescribed for each of 3 chronic condition groupings (0 or 1, 2 or 3 ≥4) (1). [Table: see text]