Does multimorbidity still remain a matter of the elderly: Lithuanian national data analysis.

INTRODUCTION: Multimorbidity - the coexistence of ≥2 chronic conditions in same individual is usually associated with older age. There is an increase in its prevalence at a much younger age, however with very limited research specifying that. OBJECTIVE: To identify age breaking points for the occurrence of multimorbidity. METHODS: The study included patients, who used any healthcare services between the 01/01/2012 and 30/06/2014. Patients were divided into two groups - with single chronic condition and with multimorbidity. Age-specific proportion of multimorbidity, rate of primary and outpatient visits, number of hospitalizations and prescribed reimbursed medications between these groups were analyzed. RESULTS: The study included 452578 patients, 94.63% of them had more than one chronic condition. The risk increase with every consecutive year for developing multimorbidity was between the age of 28 and 39 years. The age breaking point for the rapid increase in hospitalizations was about 29 years in multimorbidity group. The proportion of patients with multimorbidity using expensive medications starts to increase at the age of 41. CONCLUSIONS: The risk of acquiring an additional chronic condition rises exponentially from the age of 29 years and platos between the age of 51 and 57. Patients with multimorbidity require increasing amounts of primary healthcare resources, where patients with single chronic condition require decreasing primary care usage, possibly attributed to successful patient empowerment.

Prevalence and structure of multiple chronic conditions in Lithuanian population and the distribution of the associated healthcare resources.

BACKGROUND: Chronic multiple conditions have become a major threat to the world's healthcare systems within the last years. OBJECTIVE: To estimate the prevalence and structure of chronic conditions in Lithuania and to analyse the utilisation of healthcare resources striving to manage patients with multimorbidity. METHODS: It was based on the National Health Insurance Fund (NHIF) database, that covered the period from January, 2012 to June, 2014 and included 452,769 subjects. The prevalence of multimorbidity in Lithuania, the structure of chronic diseases within the age and gender groups as well as the association between multimorbidity and facilities usage were analysed. RESULTS: The prevalence of chronic diseases in adult Lithuanian population was 17.2%, where 94.6% (N=428 430) of the chronically diseased subjects had >1 chronic condition. The number of chronic conditions increased with the age, especially at the age of 45-54 years, and male gender (p<0.001). 10% of patients had at least 2 chronic diseases at the age of 45 and over. Multimorbidity accounted for 258,761 additional bed days per year nationally and 61% increase in the 30-day readmission rate. Primary care and outpatient visits per 1000 population were 2.1 times more prevalent and home visits were 9.6 times more frequent in multimorbid patients compared to a single chronic disease. CONCLUSIONS: Multimorbidity and its increasing prevalence among the younger patients will put additional strain on healthcare resources at an earlier stage by increasing admission, readmission rates and vastly increasing primary care contacts.