van Oostrom S H, Gijssen R, Stirbu I, Korevaar J C, Schellevis F G, Picavet H S J, Hoeymans N
*Dit onderzoek werd eerder gepubliceerd in PLoS One (2016;11:e0160264) met als titel 'Time trends in prevalence of chronic diseases and multimorbidity not only due to aging: data from general practices and health surveys'. Afgedrukt met toestemming.
Ned Tijdschr Geneeskd. 2017;161:D1429.
Chronic diseases and multimorbidity are common and expected to rise over the coming years. The objective of this study is to examine the time trend in the prevalence of chronic diseases and multimorbidity over the period 2001 till 2011 in the Netherlands, and the extent to which this can be ascribed to the aging of the population.
Monitoring study, using two data sources: 1) medical records of patients listed in a nationally representative network of general practices over the period 2002-2011, and 2) national health interview surveys over the period 2001-2011. Regression models were used to study trends in the prevalence-rates over time, with and without standardization for age.
An increase from 34.9% to 41.8% (p<0.01) in the prevalence of chronic diseases was observed in the general practice registration over the period 2004-2011 and from 41.0% to 46.6% (p<0.01) based on self-reported diseases over the period 2001-2011. Multimorbidity increased from 12.7% to 16.2% (p<0.01) and from 14.3% to 17.5% (p<0.01), respectively. Aging of the population explained part of these trends: about one-fifth based on general practice data, and one-third for chronic diseases and half of the trend for multimorbidity based on health surveys.
The prevalence of chronic diseases and multimorbidity increased over the period 2001-2011. Aging of the population only explained part of the increase, implying that other factors such as health care and society-related developments are responsible for a substantial part of this rise.
慢性疾病和多种疾病并存的情况很常见,并且预计在未来几年还会增加。本研究的目的是调查2001年至2011年期间荷兰慢性疾病和多种疾病并存情况的流行趋势,以及这在多大程度上可归因于人口老龄化。
采用监测研究,使用两个数据源:1)2002年至2011年期间全国代表性全科医疗网络中列出的患者病历,以及2)2001年至2011年期间的全国健康访谈调查。使用回归模型研究患病率随时间的趋势,包括年龄标准化和未标准化的情况。
在2004年至2011年期间的全科医疗登记中,观察到慢性疾病患病率从34.9%增加到41.8%(p<0.01),基于2001年至2011年期间自我报告疾病的数据,患病率从41.0%增加到46.6%(p<0.01)。多种疾病并存的情况分别从12.7%增加到16.2%(p<0.01)和从14.3%增加到17.5%(p<0.01)。人口老龄化解释了这些趋势的一部分:基于全科医疗数据约为五分之一,基于健康调查,慢性疾病趋势的三分之一以及多种疾病并存趋势的一半。
2001年至2011年期间,慢性疾病和多种疾病并存的患病率有所增加。人口老龄化仅解释了增加的一部分,这意味着其他因素,如医疗保健和与社会相关的发展,在很大程度上导致了这种增长。