Department of Economics and Finance, University of Rome "Tor Vergata", Rome, Italy.
Center for Health Policy, Stanford University, Stanford, California.
Aging Cell. 2019 Feb;18(1):e12861. doi: 10.1111/acel.12861. Epub 2018 Nov 29.
Aging is a strong risk factor for many chronic diseases. However, the impact of an aging population on the prevalence of chronic diseases and related healthcare costs are not known. We used a prevalence-based approach that combines accurate clinical and drug prescription data from Health Search CSD-LPD. This is a longitudinal observational data set containing computer-based patient records collected by Italian general practitioners (GP) and up-to-date healthcare expenditures data from the SiSSI Project. The analysis is based on data collected by 900 GP on an unbalanced sample of more than 1 million patients aged 35+, observed in different time periods between 2005 and 2014. In 2014, 86% of the Italian adults older than 65 had at least one chronic condition, and 56.7% had two or more. Prevalence of multiple chronic diseases and healthcare utilization increased among older and younger adults between 2004 and 2014. Indeed, in the last 10 years, average number of prescriptions increased by approximately 26%, while laboratory and diagnostic tests by 27%. The average number of DDD prescribed increased with age in all the observed years (from 114 in 2005 to 119.9 in 2014 for the 35-50 age group and from 774.9 to 1,178.1 for the 81+ patients). The alarming rising trends in the prevalence of chronic disease and associated healthcare costs in Italy, as well as in many other developed countries, call for an urgent implementation of interventions that prevent or slow the accumulation of metabolic and molecular damage associated with multiple chronic disease.
衰老是许多慢性疾病的一个重要危险因素。然而,人口老龄化对慢性病的流行和相关医疗保健费用的影响尚不清楚。我们采用了一种基于患病率的方法,该方法结合了来自 Health Search CSD-LPD 的准确临床和药物处方数据。这是一个纵向观察性数据集,包含意大利全科医生(GP)收集的基于计算机的患者记录以及 SiSSI 项目的最新医疗保健支出数据。该分析基于在 2005 年至 2014 年期间不同时间段收集的 900 名 GP 对超过 100 万 35 岁以上患者进行的不平衡样本数据进行。2014 年,86%的 65 岁以上意大利成年人至少有一种慢性疾病,56.7%有两种或更多种。2004 年至 2014 年期间,年龄较大和较小的成年人的多种慢性疾病患病率和医疗保健利用率均有所增加。事实上,在过去的 10 年中,处方的平均数量增加了约 26%,而实验室和诊断测试增加了 27%。在所有观察到的年份中,规定的 DDD 数量都随年龄增长而增加(从 2005 年的 114 增加到 2014 年的 35-50 岁年龄组的 119.9,从 2014 年的 774.9 增加到 81 岁以上患者的 1178.1)。意大利以及许多其他发达国家慢性疾病和相关医疗保健费用的患病率呈惊人上升趋势,这就需要紧急实施干预措施,以预防或减缓与多种慢性疾病相关的代谢和分子损伤的积累。