Prevalence and structure of multiple chronic conditions in Lithuanian population and the distribution of the associated healthcare resources.
BACKGROUND
Chronic multiple conditions have become a major threat to the world's healthcare systems within the last years.


OBJECTIVE
To estimate the prevalence and structure of chronic conditions in Lithuania and to analyse the utilisation of healthcare resources striving to manage patients with multimorbidity.


METHODS
It was based on the National Health Insurance Fund (NHIF) database, that covered the period from January, 2012 to June, 2014 and included 452,769 subjects. The prevalence of multimorbidity in Lithuania, the structure of chronic diseases within the age and gender groups as well as the association between multimorbidity and facilities usage were analysed.


RESULTS
The prevalence of chronic diseases in adult Lithuanian population was 17.2%, where 94.6% (N=428 430) of the chronically diseased subjects had >1 chronic condition. The number of chronic conditions increased with the age, especially at the age of 45-54 years, and male gender (p<0.001). 10% of patients had at least 2 chronic diseases at the age of 45 and over. Multimorbidity accounted for 258,761 additional bed days per year nationally and 61% increase in the 30-day readmission rate. Primary care and outpatient visits per 1000 population were 2.1 times more prevalent and home visits were 9.6 times more frequent in multimorbid patients compared to a single chronic disease.


CONCLUSIONS
Multimorbidity and its increasing prevalence among the younger patients will put additional strain on healthcare resources at an earlier stage by increasing admission, readmission rates and vastly increasing primary care contacts.
Vilnius University, Faculty of Medicine, Lithuania; Vilnius University Hospital Santariškių Klinikos, Lithuania. Electronic address: rokas.navickas@santa.lt.
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Navickas
Vilnius University, Faculty of Medicine, Lithuania; Vilnius University Hospital Santariškių Klinikos, Lithuania.
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Visockienė
Vilnius University Hospital Santariškių Klinikos, Lithuania.
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Puronaitė
Vilnius University Hospital Santariškių Klinikos, Lithuania.
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Rukšėnienė
Vilnius University, Faculty of Medicine, Lithuania; Vilnius University Hospital Santariškių Klinikos, Lithuania.
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Kasiulevičius
Vilnius University Hospital Santariškių Klinikos, Lithuania.
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Jurevičienė
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data*; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011320:Primary Health Care; D017678:Sex Distribution; D055815:Young Adult
Healthcare resources; Multimorbidity; Prevalence