Skip to main content
Erschienen in: International Journal of Public Health 6/2017

10.03.2017 | Original Article

Expansion or compression of multimorbidity? 10-year development of life years spent in multimorbidity based on health insurance claims data of Lower Saxony, Germany

verfasst von: Juliane Tetzlaff, Denise Muschik, Jelena Epping, Sveja Eberhard, Siegfried Geyer

Erschienen in: International Journal of Public Health | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Our study examined how life years spent in multimorbidity changed over a period of 10 years (2005–2014) and whether morbidity expansion or compression has taken place. There is a little evidence on whether life years gained due to increasing life expectancy are spent in good health, or if they are accompanied by morbidity expansion.

Methods

The analyses are based on German administrative claims data. Multimorbidity was defined as a combination of at least six chronic conditions and polypharmacy. After having estimated age-standardized prevalence, time trends for life years with and without multimorbidity, and the proportion of life years spent in multimorbidity (morbidity ratio) were estimated.

Results

Prevalence proportions of multimorbidity rose continuously. Increasing life expectancies were accompanied by increasing life years with multimorbidity, decreasing multimorbidity-free life years, and by an increasing morbidity ratio.

Conclusions

The lifespan spent in multimorbidity was increasing over time. Our findings indicate a growing burden of multimorbidity and an increasing proportion of life years with multiple chronic conditions. It can be concluded that an expansion of morbidity in absolute and in relative terms has occurred. The findings stress the importance of prevention, healthy lifestyles, and improved medical care strategies meeting the specific requirements of patients with multimorbidity.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
Zurück zum Zitat Chiang CL (1984) The life table and its applications. Krieger, Malabar Chiang CL (1984) The life table and its applications. Krieger, Malabar
Zurück zum Zitat Doblhammer G, Kreft D, Dethloff A (2012) Life years gained. Long-term trends in mortality by causes of death in Germany and in an international perspective (Gewonnene Lebensjahre. Langfristige Trends der Sterblichkeit nach Todesursachen in Deutschland und im internationalen Vergleich). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 55(4):448–458. doi:10.1007/s00103-012-1455-x CrossRefPubMed Doblhammer G, Kreft D, Dethloff A (2012) Life years gained. Long-term trends in mortality by causes of death in Germany and in an international perspective (Gewonnene Lebensjahre. Langfristige Trends der Sterblichkeit nach Todesursachen in Deutschland und im internationalen Vergleich). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 55(4):448–458. doi:10.​1007/​s00103-012-1455-x CrossRefPubMed
Zurück zum Zitat Drivsholm T, Eplov LF, Davidsen M, Jorgensen T, Ibsen H, Hollnagel H, Borch-Johnsen K (2006) Representativeness in population-based studies: a detailed description of non-response in a Danish cohort study. Scand J Public Health 34(6):623–631. doi:10.1080/14034940600607616 CrossRefPubMed Drivsholm T, Eplov LF, Davidsen M, Jorgensen T, Ibsen H, Hollnagel H, Borch-Johnsen K (2006) Representativeness in population-based studies: a detailed description of non-response in a Danish cohort study. Scand J Public Health 34(6):623–631. doi:10.​1080/​1403494060060761​6 CrossRefPubMed
Zurück zum Zitat Geyer S, Jaunzeme J (2014) Möglichkeiten und Grenzen von Befragungsdaten und Daten gesetzlicher Krankenversicherungen. In: Swart E, Ihle P, Gothe H, Matusiewicz D (eds) Routinedaten im Gesundheitswesen: Handbuch Sekundärdatenanalyse: Grundlagen, Methoden, und Perspektiven, 2rd edn. Verlag Hans Huber, Bern, pp 223–233 Geyer S, Jaunzeme J (2014) Möglichkeiten und Grenzen von Befragungsdaten und Daten gesetzlicher Krankenversicherungen. In: Swart E, Ihle P, Gothe H, Matusiewicz D (eds) Routinedaten im Gesundheitswesen: Handbuch Sekundärdatenanalyse: Grundlagen, Methoden, und Perspektiven, 2rd edn. Verlag Hans Huber, Bern, pp 223–233
Zurück zum Zitat Jagger C, Cox B, Le Roy S, EHEMU (2006) Health expectancy calculation by the Sullivan Method. Third Edition. EHEMU Technical Report Jagger C, Cox B, Le Roy S, EHEMU (2006) Health expectancy calculation by the Sullivan Method. Third Edition. EHEMU Technical Report
Zurück zum Zitat Jaunzeme J, Eberhard S, Geyer S (2013) Wie “repräsentativ” sind GKV-Daten? Demografische und soziale Unterschiede und Ähnlichkeiten zwischen einer GKV-Versichertenpopulation, der Bevölkerung Niedersachsens sowie der Bundesrepublik am Beispiel der AOK Niedersachsen (How “representative” are SHI (statutory health insurance) data? Demographic and social differences and similarities between an SHI-insured population, the population of Lower Saxony, and that of the Federal Republic of Germany using the example of the AOK in Lower Saxony). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56(3):447–454. doi:10.1007/s00103-012-1626-9 CrossRefPubMed Jaunzeme J, Eberhard S, Geyer S (2013) Wie “repräsentativ” sind GKV-Daten? Demografische und soziale Unterschiede und Ähnlichkeiten zwischen einer GKV-Versichertenpopulation, der Bevölkerung Niedersachsens sowie der Bundesrepublik am Beispiel der AOK Niedersachsen (How “representative” are SHI (statutory health insurance) data? Demographic and social differences and similarities between an SHI-insured population, the population of Lower Saxony, and that of the Federal Republic of Germany using the example of the AOK in Lower Saxony). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56(3):447–454. doi:10.​1007/​s00103-012-1626-9 CrossRefPubMed
Zurück zum Zitat Manton KG (1982) Changing concepts of morbidity and mortality in the elderly population. Milbank Mem Fund Q Health Soc 60(2):183–244CrossRefPubMed Manton KG (1982) Changing concepts of morbidity and mortality in the elderly population. Milbank Mem Fund Q Health Soc 60(2):183–244CrossRefPubMed
Zurück zum Zitat Meslé F, Vallin J (2006) The health transition: trends and prospects. In: Caselli G, Vallin J, Wunsch GJ (eds) Demography: analysis and synthesis. a treatise in population studies, vol 2. Academic, New York, pp 247–259 Meslé F, Vallin J (2006) The health transition: trends and prospects. In: Caselli G, Vallin J, Wunsch GJ (eds) Demography: analysis and synthesis. a treatise in population studies, vol 2. Academic, New York, pp 247–259
Zurück zum Zitat R Team RC (2014) A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna R Team RC (2014) A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna
Zurück zum Zitat Ramond-Roquin A, Haggerty J, Lambert M, Almirall J, Fortin M (2016) Different multimorbidity measures result in varying estimated levels of physical quality of life in individuals with multimorbidity: a cross-sectional study in the general population. Biomed Res Int 2016:7845438. doi:10.1155/2016/7845438 CrossRefPubMedPubMedCentral Ramond-Roquin A, Haggerty J, Lambert M, Almirall J, Fortin M (2016) Different multimorbidity measures result in varying estimated levels of physical quality of life in individuals with multimorbidity: a cross-sectional study in the general population. Biomed Res Int 2016:7845438. doi:10.​1155/​2016/​7845438 CrossRefPubMedPubMedCentral
Zurück zum Zitat Rinne ST, Wong ES, Lemon JM, Perkins M, Bryson CL, Liu C (2015) Survey nonresponders incurred higher medical utilization and lower medication adherence. Am J Manag Care 21(1):e1–e8PubMed Rinne ST, Wong ES, Lemon JM, Perkins M, Bryson CL, Liu C (2015) Survey nonresponders incurred higher medical utilization and lower medication adherence. Am J Manag Care 21(1):e1–e8PubMed
Zurück zum Zitat Robert Koch-Institut (2015) Gesundheit in Deutschland. Gesundheitsberichterstattung des Bundes—Gemeinsam getragen von RKI und Destatis, Berlin Robert Koch-Institut (2015) Gesundheit in Deutschland. Gesundheitsberichterstattung des Bundes—Gemeinsam getragen von RKI und Destatis, Berlin
Zurück zum Zitat Robine J, Jagger C (2005) The relationship between increasing life expectancy and healthy life expectancy. Ageing Horizons 3:14–21 Robine J, Jagger C (2005) The relationship between increasing life expectancy and healthy life expectancy. Ageing Horizons 3:14–21
Zurück zum Zitat StataCorp (2013) Stata Statistical Software: Release 13. StataCorp LP, College Station StataCorp (2013) Stata Statistical Software: Release 13. StataCorp LP, College Station
Zurück zum Zitat Sullivan DF (1971) A single index of mortality and morbidity. HSMHA. Health Rep 86(4):347–354 Sullivan DF (1971) A single index of mortality and morbidity. HSMHA. Health Rep 86(4):347–354
Zurück zum Zitat Tetzlaff J, Junius-Walker U, Muschik D, Epping J, Eberhard S, Geyer S (2016) Identifying time trends in multimorbidity—defining multimorbidity in times of changing diagnostic practices. J Public Health. doi:10.1007/s10389-016-0771-2 Tetzlaff J, Junius-Walker U, Muschik D, Epping J, Eberhard S, Geyer S (2016) Identifying time trends in multimorbidity—defining multimorbidity in times of changing diagnostic practices. J Public Health. doi:10.​1007/​s10389-016-0771-2
Zurück zum Zitat Trachte F, Sperlich S, Geyer S (2015) Kompression oder Expansion der Morbidität? Entwicklung der Gesundheit in der älteren Bevölkerung (Compression or expansion of morbidity? Development of health among the older population). Z Gerontol Geriatr 48(3):255–262. doi:10.1007/s00391-014-0644-7 CrossRefPubMed Trachte F, Sperlich S, Geyer S (2015) Kompression oder Expansion der Morbidität? Entwicklung der Gesundheit in der älteren Bevölkerung (Compression or expansion of morbidity? Development of health among the older population). Z Gerontol Geriatr 48(3):255–262. doi:10.​1007/​s00391-014-0644-7 CrossRefPubMed
Zurück zum Zitat Valkonen T (2006) Social inequalities in mortality. In: Caselli G, Vallin J, Wunsch GJ (eds) Demography: analysis and synthesis. a treatise in population studies. Academic, New York, pp 195–206 Valkonen T (2006) Social inequalities in mortality. In: Caselli G, Vallin J, Wunsch GJ (eds) Demography: analysis and synthesis. a treatise in population studies. Academic, New York, pp 195–206
Zurück zum Zitat van den Bussche H, Scherer M (2011) Das Verbundvorhaben “Komorbidität und Multimorbidität in der hausärztlichen Versorgung” (MultiCare) (The joint research project “Comorbidity and multimorbidity in primary care” (MultiCare)). Z Gerontol Geriatr 44(Suppl 2):73–100. doi:10.1007/s00391-011-0249-3 CrossRefPubMed van den Bussche H, Scherer M (2011) Das Verbundvorhaben “Komorbidität und Multimorbidität in der hausärztlichen Versorgung” (MultiCare) (The joint research project “Comorbidity and multimorbidity in primary care” (MultiCare)). Z Gerontol Geriatr 44(Suppl 2):73–100. doi:10.​1007/​s00391-011-0249-3 CrossRefPubMed
Zurück zum Zitat van den Akker M, Buntinx F, Knottnerus JA (1996) Comorbidity or multimorbidity: what’s in a name? A review of literature. Eur J Gen Pract 2(2):65–70CrossRef van den Akker M, Buntinx F, Knottnerus JA (1996) Comorbidity or multimorbidity: what’s in a name? A review of literature. Eur J Gen Pract 2(2):65–70CrossRef
Zurück zum Zitat Walter S, Beltran-Sanchez H, Regidor E, Gomez-Martin C, Del-Barrio JL, Gil-de-Miguel A, Subramanian SV, Gil-Prieto R (2016) No evidence of morbidity compression in Spain: a time series study based on national hospitalization records. Int J Public Health. doi:10.1007/s00038-016-0829-5 PubMed Walter S, Beltran-Sanchez H, Regidor E, Gomez-Martin C, Del-Barrio JL, Gil-de-Miguel A, Subramanian SV, Gil-Prieto R (2016) No evidence of morbidity compression in Spain: a time series study based on national hospitalization records. Int J Public Health. doi:10.​1007/​s00038-016-0829-5 PubMed
Zurück zum Zitat WHO (2014) Global Status Report on noncommunicable diseases 2014. World Health Organization, Geneva WHO (2014) Global Status Report on noncommunicable diseases 2014. World Health Organization, Geneva
Zurück zum Zitat WHO Collaborating Centre for Drug Statistics Methodology (2015) Guidelines for ATC classification and DDD assignment 2015, Oslo WHO Collaborating Centre for Drug Statistics Methodology (2015) Guidelines for ATC classification and DDD assignment 2015, Oslo
Metadaten
Titel
Expansion or compression of multimorbidity? 10-year development of life years spent in multimorbidity based on health insurance claims data of Lower Saxony, Germany
verfasst von
Juliane Tetzlaff
Denise Muschik
Jelena Epping
Sveja Eberhard
Siegfried Geyer
Publikationsdatum
10.03.2017
Verlag
Springer International Publishing
Erschienen in
International Journal of Public Health / Ausgabe 6/2017
Print ISSN: 1661-8556
Elektronische ISSN: 1661-8564
DOI
https://doi.org/10.1007/s00038-017-0962-9

Weitere Artikel der Ausgabe 6/2017

International Journal of Public Health 6/2017 Zur Ausgabe