Health-related needs of people with multiple chronic diseases: differences and underlying factors.
OBJECTIVE
To examine the health-related needs of people with multiple chronic diseases in the Netherlands compared to people with one chronic disease, and to identify different subgroups of multimorbid patients based on differences in their health problems.


METHODS
Participants were 1092 people with one or more chronic diseases of a nationwide prospective panel study on the consequences of chronic illness in the Netherlands. They completed the EQ-6D, a multi-dimensional questionnaire on health problems (October 2013). Chi-square tests and analyses of variance were performed to test for differences between multimorbid patients and patients with one chronic disease. To identify subgroups of multimorbid patients, cluster analysis was performed and differences in EQ-6D scores between clusters were tested with Chi-square tests.


RESULTS
Multimorbid patients (51 % of the total sample) experience more problems in most health domains than patients with one chronic disease. Almost half (44 %) of the multimorbid people had many health problems in different domains. These people were more often female, had a smaller household size, had a lower health literacy, and suffered from more chronic diseases. Remarkably, a small subgroup of multimorbid patients (4 %, mostly elderly males) is characterized by all having cognitive problems.


CONCLUSIONS
Based on the problems they experience, we conclude that patients with multimorbidity have relatively many and diverse health-related needs. Extensive health-related needs among people with multimorbidity may relate not only to the number of chronic diseases they suffer from, but also to their patient characteristics. This should be taken into account, when identifying target groups for comprehensive support programmes.
Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN, Utrecht, The Netherlands. epchopman@hetnet.nl.
Petra
P
Hopman
Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN, Utrecht, The Netherlands.|Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
François G
FG
Schellevis
Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN, Utrecht, The Netherlands. M.Rijken@nivel.nl.
Mieke
M
Rijken
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D057220:Health Literacy; D006301:Health Services Needs and Demand; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands; D011446:Prospective Studies; D011788:Quality of Life; D055815:Young Adult
Chronic disease; Health problems; Health survey; Multimorbidity; Needs; Netherlands; Quality of life