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The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada

BACKGROUND: The prevalence of multiple chronic diseases is increasing and is a common problem for primary health care providers. This study sought to determine the patient and health system burden of multiple chronic diseases among adults in Ontario, Canada, with a focus on the ambulatory health car...

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Autores principales: Muggah, Elizabeth, Graves, Erin, Bennett, Carol, Manuel, Douglas G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532841/
https://www.ncbi.nlm.nih.gov/pubmed/23217125
http://dx.doi.org/10.1186/1472-6963-12-452
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author Muggah, Elizabeth
Graves, Erin
Bennett, Carol
Manuel, Douglas G
author_facet Muggah, Elizabeth
Graves, Erin
Bennett, Carol
Manuel, Douglas G
author_sort Muggah, Elizabeth
collection PubMed
description BACKGROUND: The prevalence of multiple chronic diseases is increasing and is a common problem for primary health care providers. This study sought to determine the patient and health system burden of multiple chronic diseases among adults in Ontario, Canada, with a focus on the ambulatory health care system (outpatient primary health care and specialist services). METHODS: This population-based study used linked health administrative data from Ontario, Canada. Individuals, aged 20 years or older, who had a valid health card, were included. Validated case definitions were used to identify persons with at least one of the following nine chronic diseases: diabetes, congestive heart failure, acute myocardial infarction, stroke, hypertension, asthma, chronic obstructive lung disease, peripheral vascular disease and end stage renal failure. Prevalence estimates for chronic diseases were calculated for April 1, 2009. Ambulatory physician billing records for the two-year period, April 1, 2008 to March 31, 2010, were used to identify the number of outpatient ambulatory care visits. RESULTS: In 2009, 26.3% of Ontarians had one chronic disease, 10.3% had two diseases, and 5.6% had three or more diseases. Annual mean primary health care use increased significantly with each additional chronic disease. Overall, there were twice as many patient visits to primary health care providers compared to specialists across all chronic disease counts. Among those with multiple diseases, primary health care visits increased with advancing age, while specialist care dropped off. While persons with three or more diseases accounted for a disproportionate share of primary health care visits, the largest number of visits were made by those with no or one chronic disease. CONCLUSIONS: The burden of care for persons with multiple chronic diseases is considerable and falls largely on the primary health care provider. However persons with no or one chronic disease are responsible for the largest number of ambulatory health care visits overall. Continued investment in primary health care is needed both to care for those with multiple diseases and to prevent the accumulation of chronic diseases with aging.
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spelling pubmed-35328412013-01-03 The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada Muggah, Elizabeth Graves, Erin Bennett, Carol Manuel, Douglas G BMC Health Serv Res Research Article BACKGROUND: The prevalence of multiple chronic diseases is increasing and is a common problem for primary health care providers. This study sought to determine the patient and health system burden of multiple chronic diseases among adults in Ontario, Canada, with a focus on the ambulatory health care system (outpatient primary health care and specialist services). METHODS: This population-based study used linked health administrative data from Ontario, Canada. Individuals, aged 20 years or older, who had a valid health card, were included. Validated case definitions were used to identify persons with at least one of the following nine chronic diseases: diabetes, congestive heart failure, acute myocardial infarction, stroke, hypertension, asthma, chronic obstructive lung disease, peripheral vascular disease and end stage renal failure. Prevalence estimates for chronic diseases were calculated for April 1, 2009. Ambulatory physician billing records for the two-year period, April 1, 2008 to March 31, 2010, were used to identify the number of outpatient ambulatory care visits. RESULTS: In 2009, 26.3% of Ontarians had one chronic disease, 10.3% had two diseases, and 5.6% had three or more diseases. Annual mean primary health care use increased significantly with each additional chronic disease. Overall, there were twice as many patient visits to primary health care providers compared to specialists across all chronic disease counts. Among those with multiple diseases, primary health care visits increased with advancing age, while specialist care dropped off. While persons with three or more diseases accounted for a disproportionate share of primary health care visits, the largest number of visits were made by those with no or one chronic disease. CONCLUSIONS: The burden of care for persons with multiple chronic diseases is considerable and falls largely on the primary health care provider. However persons with no or one chronic disease are responsible for the largest number of ambulatory health care visits overall. Continued investment in primary health care is needed both to care for those with multiple diseases and to prevent the accumulation of chronic diseases with aging. BioMed Central 2012-12-10 /pmc/articles/PMC3532841/ /pubmed/23217125 http://dx.doi.org/10.1186/1472-6963-12-452 Text en Copyright ©2012 Muggah et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Muggah, Elizabeth
Graves, Erin
Bennett, Carol
Manuel, Douglas G
The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada
title The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada
title_full The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada
title_fullStr The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada
title_full_unstemmed The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada
title_short The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada
title_sort impact of multiple chronic diseases on ambulatory care use; a population based study in ontario, canada
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532841/
https://www.ncbi.nlm.nih.gov/pubmed/23217125
http://dx.doi.org/10.1186/1472-6963-12-452
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