Prevalence of multimorbidity in Emilia-Romagna Region from 2008 to 2012

Background The rising prevalence of chronic diseases and management of multimorbidity represent a main challenge for health care systems worldwide, as it correlates with high use of health services resources over time. Prevalence estimates of multimorbidity vary widely among countries, as neither a widely accepted definition has been stated nor standard approach for measuring the phenomenon has been established so far. The aim of this study was to describe the prevalence of multimorbidity in Emilia-Romagna region (Northern Italy). Methods Multimorbidity was defined as the presence of two or more chronic conditions. To assess multimorbidity, patients (aged ≥ 18 years) were classified according to Charlson's algorithm, integrated with some categories retrieved from Elixhauser's list. The prevalence of multimorbidity was calculated using information on hospitalizations and drug therapies retrieved from administrative databases between 2008 and 2012. Results From 2008 to 2012, 905707 persons living in Emilia-Romagna region had one chronic condition (prevalence of 24.4%), whereas 604856 had multimorbidity (prevalence of 16.3%). The prevalence of multimorbidity was higher in men and increased with age: by age 60 years, half of the population had at least one chronic disease, and by the age 70 years 30% had multimorbidity. The most prevalent chronic condition was hypertension (35.6%), followed by diabetes (7.6%), cancer (4.9%), stroke (4.0%) and heart failure (3.4%). The prevalence of one chronic disease and that of multimorbidity was lower in immigrants than in Italian citizens, probably due to a “healthy immigrant effect”. However, in immigrants the age-standardized prevalence of multimorbidity was higher than the prevalence of one chronic disease. Conclusions Multimorbidity occurred in a high percentage of Emilia-Romagna population, especially in the elderly. The analysis also revealed a different prevalence of multimorbidity by citizenship, implying a different burden of health care by citizenship and suggesting that more efforts are needed to guarantee migrant-sensitive health care. Future perspectives include retrieving information on mental health, to provide a strong evidence base for the care and management of patients with multimorbidity