Chronic conditions and use of health care service among German centenarians.
there is limited data comparing conditions and health service use across care settings in centenarians. To improve health service delivery in centenarians, the aim of this study was to compare the proportion of centenarians who have chronic conditions, take medication and use health care services across different care settings.



this cohort study uses routine data from a major health insurance company serving Berlin, Germany and the surrounding region, containing almost complete information on health care transactions. The sample comprised all insured individuals aged 100 years and older (N = 1,121). Community-dwelling and institutionalised individuals were included. Charlson comorbidity index was based on 5 years of recordings. Hospital stays, medical specialist visits and medication prescribed in the previous year were analysed.



while 6% of the centenarians did not receive any support; 45% received family homecare or homecare by professional care services; 49% were in long-term care. The most frequent conditions were dementia and rheumatic disease/arthritis, with the highest prevalence found among long-term care residents. A total of 97% of the centenarians saw a general practitioner in the previous year. Women were more often in long-term care and less often without any care. Centenarians with long-term care showed higher proportions of comorbidities, greater medication use, and more visits to medical specialists compared with centenarians in other care settings.



the higher prevalence of dementia and rheumatic disease/arthritis in long-term care compared to other care settings emphasises the role of these diseases in relation to the loss of physical and cognitive functioning.
Institute of Medical Sociology, Charité Universitätsmedizin Berlin, Berlin, Germany.|Department of General, Visceral and Vascular Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
Petra
P
von Berenberg
Institute of Medical Sociology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Dagmar
D
Dräger
GeWINO-Health Research Institute, AOK Nordost, Berlin, Germany.
Thomas
T
Zahn
GeWINO-Health Research Institute, AOK Nordost, Berlin, Germany.
Julia
J
Neuwirth
Institute of Medical Sociology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Adelheid
A
Kuhlmey
Institute of Medical Sociology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Paul
P
Gellert
D000067575:Administrative Claims, Healthcare; D000367:Age Factors; D000369:Aged, 80 and over; D000375:Aging; D001168:Arthritis / Q000453:epidemiology / Q000628:therapy; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D016208:Databases, Factual; D003704:Dementia / Q000453:epidemiology / Q000628:therapy; D011307:Drug Prescriptions; D005260:Female; D015577:Geriatric Assessment; D005858:Germany; D006295:Health Resources / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D000076322:Multimorbidity; D009819:Office Visits / Q000706:statistics & numerical data; D010343:Patient Admission; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012216:Rheumatic Diseases / Q000453:epidemiology / Q000628:therapy
health services; insurance data; longevity; medication; multimorbidity; older people