Prevalence of chronic conditions and multimorbidity in Estonia: a population-based cross-sectional study

Abstract

ObjectivesPrevalence estimates for specific chronic conditions and multimorbidity (MM) in eastern Europe are scarce. This national study estimates the prevalence of MM by age group and sex in Estonia.DesignA population-based cross-sectional study, using administrative data.SettingData were collected on 55 chronic conditions from the Estonian Health Insurance Fund from 2015 to 2017. MM was defined as the coexistence of two or more conditions.ParticipantsThe Estonian Health Insurance Fund includes data for approximately 95% of the Estonian population receiving public health insurance.Primary and secondary outcome measuresPrevalence and 95% CIs for MM stratified by age group and sex.ResultsNearly half (49.1%) of the individuals (95% CI 49.0 to 49.3) had at least 1 chronic condition, and 30.1% (95% CI 30.0 to 30.2) had MM (2 or more chronic conditions). The number of conditions and the prevalence of MM increased with age, ranging from an MM prevalence of 3.5% (3.5%–3.6%) in the youngest (0–24 years) to as high as 80.4% (79.4%–81.3%) in the oldest (≥85 years) age group. Half of all individuals had MM by 60 years of age, and 75% of the population had MM by 75 years of age. Women had a higher prevalence of MM (34.9%, 95% CI 34.7 to 35.0) than men (24.4%, 95% CI 24.3 to 24.5). Hypertension was the most frequent chronic condition (24.5%), followed by chronic pain (12.4%) and arthritis (7.7%).ConclusionsHypertension is an important chronic condition amenable to treatment with lifestyle and therapeutic interventions. Given the established correlation between uncontrolled hypertension and exacerbation of other cardiovascular conditions as well as acute illnesses, this most common condition within the context of MM may be suitable for targeted public health interventions.

Prevalence of and factors associated with multimorbidity among 18 101 adults in the South East Asia Community Observatory Health and Demographic Surveillance System in Malaysia: a population-based, cross-sectional study of the MUTUAL consortium

“…Our findings are in agreement with the known paradox and other studies that multimorbidity increases with age, as long-term diseases accumulate with age. 10 25 It is interesting to note that in our study population, older age only explained part of the augmented risk of multimorbidity. We identified that other factors (sex, education level and employment status) are responsible for a substantial part of the association with multimorbidity.…”

“…Consequently, it has not been possible to evaluate and develop patient-centred prevention and treatment strategies targeting multimorbidity and such risk factors. The COVID-19 pandemic further drew attention to the crucial contribution of multimorbidity to the need for sound public health measures and rapid identification of effective medical interventions grounded on risk stratification 10. To better manage the consequences of such an adverse phenomenon, a better understanding of the prevalence and factors associated with multimorbidity among diverse study populations became essential.…”

Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis

“… 154 Brazil UMIC 2020 2015 Cross-sectional The ISA-Capital health survey Self-reported and Objective 1019 ≥60 67.7 40.3 10 40 Jürisson et al. 155 Estonia HIC 2021 2015–2017 Cross-sectional Estonian Health Insurance Fund Objective 909,477 ≥25 53.4 45.9 55 39.8 a Ascertainment of morbidities- Objective: medical records/clinical examinations. …”

Physical-mental health comorbidity: A population-based cross-sectional study

“…Study subjects were assigned a unique identifier decoupled from personal identification information to enable longitudinal tracking of care while maintaining patient privacy. The same database and methodology were used when analyzing MM prevalence in Estonia [ 13 ].…”