Trends in age‐related disease burden and healthcare utilization

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.

[1]  L. Masserini.  L'uso dei farmaci in Italia , 2008 .

[2]  Alan D. Lopez,et al.  Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2014, The Lancet.

[3]  Shengshou Hu,et al.  National trend in congenital heart disease mortality in China during 2003 to 2010: a population-based study. , 2014, The Journal of thoracic and cardiovascular surgery.

[4]  William D. Marder,et al.  Multiple Chronic Conditions: Prevalence, Health Consequences, and Implications for Quality, Care Management, and Costs , 2007, Journal of General Internal Medicine.

[5]  B. Kennedy,et al.  Medical research: Treat ageing , 2014, Nature.

[6]  A. Feigl,et al.  The Global Economic Burden of Noncommunicable Diseases , 2012 .

[7]  S. Olshansky,et al.  A potential decline in life expectancy in the United States in the 21st century. , 2005, The New England journal of medicine.

[8]  Marie Schmidt,et al.  HEAL TH AT A GLANCE , 2007 .

[9]  V. Atella,et al.  Excess body weight increases the burden of age-associated chronic diseases and their associated health care expenditures , 2015, Aging.

[10]  T. Wadden,et al.  Mechanisms, Pathophysiology, and Management of Obesity , 2017, The New England journal of medicine.

[11]  J. Vaupel,et al.  Ageing populations: the challenges ahead , 2009, The Lancet.

[12]  R. Lawrenson,et al.  Clinical information for research; the use of general practice databases. , 1999, Journal of public health medicine.

[13]  G. Mazzaglia,et al.  Computerized general practice databases provide quick and cost-effective information on the prevalence of angina pectoris. , 2005, Italian heart journal : official journal of the Italian Federation of Cardiology.

[14]  A. Blokstra,et al.  Today's adult generations are less healthy than their predecessors: generation shifts in metabolic risk factors: the Doetinchem Cohort Study , 2014, European journal of preventive cardiology.

[15]  Hugh Tunstall-Pedoe,et al.  Preventing Chronic Diseases. A Vital Investment: WHO Global Report. Geneva: World Health Organization, 2005. pp 200. CHF 30.00. ISBN 92 4 1563001. Also published on http://www.who.int/chp/chronic_disease_report/en/ , 2006 .

[16]  Kenneth S Boockvar,et al.  Recent trends in chronic disease, impairment and disability among older adults in the United States , 2011, BMC geriatrics.

[17]  A. Palma,et al.  The 'Double Expansion of Morbidity' Hypothesis: Evidence from Italy , 2018 .

[18]  C. Brindis,et al.  Trends in adolescent and young adult health in the United States. , 2009, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[19]  B. Starfield,et al.  Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. , 2002, Archives of internal medicine.

[20]  Hwajung Choi,et al.  Health Of Americans Who Must Work Longer To Reach Social Security Retirement Age. , 2017, Health affairs.

[21]  David A Mayer-Foulkes,et al.  A Survey of Macro Damages from Non-Communicable Chronic Diseases: Another Challenge for Global Governance , 2011 .

[22]  A. Case,et al.  Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century , 2015, Proceedings of the National Academy of Sciences.

[23]  F. Hu,et al.  Optimal body weight for health and longevity: bridging basic, clinical, and population research , 2014, Aging cell.

[24]  B. Leff,et al.  Systematic Review of Programs Treating High-Need and High-Cost People With Multiple Chronic Diseases or Disabilities in the United States, 2008–2014 , 2015, Preventing chronic disease.