ArticlePloS one2020
The disease burden of multimorbidity and its interaction with educational level.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 42 citations in OpenAlex.
- Socioeconomic Disparities in Cardiovascular Health: A Cross-Sectional Analysis Unpacking the Sequential Mediation Roles of Protein Intake and Handgrip Strength.Healthcare (Basel, Switzerland) · 2026Article
- The impact of multimorbidity on the occurrence of depression among middle-aged and elderly people in China.PloS one · 2026Article
- Article
- Impact of somatic comorbidities on healthcare costs in patients with severe mental disorders: a cross-sectional study in Beijing.BMC psychiatry · 2025Article
- Lifetime Healthcare and Long-Term Care Costs of Heart Failure: Estimates Using Administrative Data from Hospitalized Patients in the Netherlands.PharmacoEconomics · 2025Article
- Temporal trends in socioeconomic inequalities and risk of infection after hip fracture surgery: a nationwide cohort study, 2010-2021.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Self-Care in Patients With Inflammatory Bowel Disease: A Descriptive Cross-Sectional Multicenter Study.Crohn's & colitis 360 · 2025Article
- Co-creating a person-centred approach in primary care for patients with low socioeconomic status and chronic conditions:Primary health care research & development · 2025Article
- Characterizing a heterogeneous chronic patient population for redesigning person-centred bundled payment models using risk-mitigating measures.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- Multimorbidity Patterns and Depression: Bridging Epidemiological Associations with Predictive Analytics for Risk Stratification.Healthcare (Basel, Switzerland) · 2025Article
- Patient experiences with person-centred and integrated chronic care, focusing on patients with low socioeconomic status: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- The impact of perceived social support on chronic disease self-management among older inpatients in China: The chain-mediating roles of psychological resilience and health empowerment.BMC geriatrics · 2025Article
- Co-Occurring Diseases and Mortality in Patients With Chronic Heart Disease, Modeling Their Dynamically Expanding Disease Portfolios: Nationwide Register Study.JMIR cardio · 2025Article
- Latent profile analysis of fatalism and its influencing factors among community-dwelling disabled elderly individuals.Frontiers in psychology · 2025Article
- The Association Between Socioeconomic Position and Infection Risk After Hip Fracture Surgery: A Nationwide Cohort Study of 54,853 Patients.Clinical epidemiology · 2025Article
- The Chinese version of patient experience with treatment and self-management (PETS vs. 2.0): translation and validation in patients with multimorbidity in primary care in Hong Kong.Journal of patient-reported outcomes · 2024Article
- Social determinants of health and emergency department visits among older adults with multimorbidity: insight from 2010 to 2018 National Health Interview Survey.BMC public health · 2024Article
- Article
- Multimorbidity and its associated risk factors among adults in northern Sudan: a community-based cross-sectional study.Journal of health, population, and nutrition · 2024Article
- Experiences of hospital care for people with multiple long-term conditions: a scoping review of qualitative research.BMC medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPolicies to adequately respond to the rise in multimorbidity have top-priority. To understand the actual burden of multimorbidity, this study aimed to: 1) estimate the trend in prevalence of multimorbidity in the Netherlands, 2) study the association between multimorbidity and physical and mental health outcomes and healthcare cost, and 3) investigate how the association between multimorbidity and health outcomes interacts with socio-economic status (SES).
methodsPrevalence estimates were obtained from a nationally representative pharmacy database over 2007-2016. Impact on costs was estimated in a fixed effect regression model on claims data over 2009-2015. Data on physical and mental health and SES were obtained from the National Health Survey in 2017, in which the Katz-10 was used to measure limitations in activities of daily living (ADL) and the Mental Health Inventory (MHI) to measure mental health. SES was approximated by the level of education. Generalized linear models (2-part models for ADL) were used to analyze the health data. In all models an indicator variable for the presence or absence of multimorbidity was included or a categorical variable for the number of chronic conditions. Interactions terms of multimorbidity and educational level were added into the previously mentioned models.
resultsOver the past ten years, there was an increase of 1.6%-point in the percentage of people with multimorbidity. The percentage of people with three or more conditions increased with +2.1%-point. People with multimorbidity had considerably worse physical and mental health outcomes than people without multimorbidity. For the ADL, the impact of multimorbidity was three times greater in the lowest educational level than in the highest educational level. For the MHI, the impact of multimorbidity was two times greater in the lowest than in the highest educational level. Each additional chronic condition was associated with a greater worsening in health outcomes. Similarly, for costs, where there was no evidence of a diminishing impact of additional conditions either. In patients with multimorbidity total healthcare costs were on average €874 higher than in patients with a single morbidity.
conclusionThe impact of multimorbidity on health and costs seems to be greater in the sicker and lower educated population.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.