Evidence map›Paper›PMID 33619067›Full record

Observational studyCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2021

Trends in prevalence of chronic disease and multimorbidity in Ontario, Canada.

Mitch Steffler, Yin Li, Sharada Weir, Shaun Shaikh, Farshad Murtada, James G Wright, Jasmin Kantarevic

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 2 pooled it
6.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Mitch StefflerEconomics, Policy & Research Department (Steffler, Li, Weir, Shaikh, Murtada, Wright, Kantarevic), Ontario Medical Association; Canadian Centre for Health Economics (Steffler, Weir, Kantarevic), University of Toronto, Toronto, Ont.; University of Western Ontario (Murtada), London, Ont.; Departments of Surgery and Public Health Sciences (Wright), and Institute of Health Policy, Management and Evaluation (Wright, Kantarevic), and Deparment of Economics (Kantarevic), University of Toronto, Toronto, Ont.; Institute of Labour Economics (Kantarevic), Deutsche Post Foundation, Bonn, Germany mitch.steffler@oma.org.
Yin LiEconomics, Policy & Research Department (Steffler, Li, Weir, Shaikh, Murtada, Wright, Kantarevic), Ontario Medical Association; Canadian Centre for Health Economics (Steffler, Weir, Kantarevic), University of Toronto, Toronto, Ont.; University of Western Ontario (Murtada), London, Ont.; Departments of Surgery and Public Health Sciences (Wright), and Institute of Health Policy, Management and Evaluation (Wright, Kantarevic), and Deparment of Economics (Kantarevic), University of Toronto, Toronto, Ont.; Institute of Labour Economics (Kantarevic), Deutsche Post Foundation, Bonn, Germany.
Sharada WeirEconomics, Policy & Research Department (Steffler, Li, Weir, Shaikh, Murtada, Wright, Kantarevic), Ontario Medical Association; Canadian Centre for Health Economics (Steffler, Weir, Kantarevic), University of Toronto, Toronto, Ont.; University of Western Ontario (Murtada), London, Ont.; Departments of Surgery and Public Health Sciences (Wright), and Institute of Health Policy, Management and Evaluation (Wright, Kantarevic), and Deparment of Economics (Kantarevic), University of Toronto, Toronto, Ont.; Institute of Labour Economics (Kantarevic), Deutsche Post Foundation, Bonn, Germany.
Shaun ShaikhEconomics, Policy & Research Department (Steffler, Li, Weir, Shaikh, Murtada, Wright, Kantarevic), Ontario Medical Association; Canadian Centre for Health Economics (Steffler, Weir, Kantarevic), University of Toronto, Toronto, Ont.; University of Western Ontario (Murtada), London, Ont.; Departments of Surgery and Public Health Sciences (Wright), and Institute of Health Policy, Management and Evaluation (Wright, Kantarevic), and Deparment of Economics (Kantarevic), University of Toronto, Toronto, Ont.; Institute of Labour Economics (Kantarevic), Deutsche Post Foundation, Bonn, Germany.
Farshad MurtadaEconomics, Policy & Research Department (Steffler, Li, Weir, Shaikh, Murtada, Wright, Kantarevic), Ontario Medical Association; Canadian Centre for Health Economics (Steffler, Weir, Kantarevic), University of Toronto, Toronto, Ont.; University of Western Ontario (Murtada), London, Ont.; Departments of Surgery and Public Health Sciences (Wright), and Institute of Health Policy, Management and Evaluation (Wright, Kantarevic), and Deparment of Economics (Kantarevic), University of Toronto, Toronto, Ont.; Institute of Labour Economics (Kantarevic), Deutsche Post Foundation, Bonn, Germany.
James G WrightEconomics, Policy & Research Department (Steffler, Li, Weir, Shaikh, Murtada, Wright, Kantarevic), Ontario Medical Association; Canadian Centre for Health Economics (Steffler, Weir, Kantarevic), University of Toronto, Toronto, Ont.; University of Western Ontario (Murtada), London, Ont.; Departments of Surgery and Public Health Sciences (Wright), and Institute of Health Policy, Management and Evaluation (Wright, Kantarevic), and Deparment of Economics (Kantarevic), University of Toronto, Toronto, Ont.; Institute of Labour Economics (Kantarevic), Deutsche Post Foundation, Bonn, Germany.
Jasmin KantarevicEconomics, Policy & Research Department (Steffler, Li, Weir, Shaikh, Murtada, Wright, Kantarevic), Ontario Medical Association; Canadian Centre for Health Economics (Steffler, Weir, Kantarevic), University of Toronto, Toronto, Ont.; University of Western Ontario (Murtada), London, Ont.; Departments of Surgery and Public Health Sciences (Wright), and Institute of Health Policy, Management and Evaluation (Wright, Kantarevic), and Deparment of Economics (Kantarevic), University of Toronto, Toronto, Ont.; Institute of Labour Economics (Kantarevic), Deutsche Post Foundation, Bonn, Germany.
Deutsche Post (Germany) · DEOntario Medical Association · CAKantar Health (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNew case-mix tools from the Canadian Institute for Health Information offer a novel way of exploring the prevalence of chronic disease and multimorbidity using diagnostic data. We took a comprehensive approach to determine whether the prevalence of chronic disease and multimorbidity has been rising in Ontario, Canada.

methodsIn this observational study, we applied case-mix methodology to a population-based cohort. We used 10 years of patient-level data (fiscal years 2008/09 to 2017/18) from multiple care settings to compute the rolling 5-year prevalence of 85 chronic diseases and multimorbidity (i.e., the co-occurrence of 2 or more diagnoses). Diseases were further classified based on type and severity. We report both crude and age- and sex-standardized trends.

resultsThe number of patients with chronic disease increased by 11.0% over the 10-year study period to 9.8 million in 2017/18, and the number with multimorbidity increased 12.2% to 6.5 million. Overall increases from 2008/09 to 2017/18 in the crude prevalence of chronic conditions and multimorbidity were driven by population aging. After adjustments for age and sex, the prevalence of patients with ≥ 1 chronic conditions decreased from 70.2% to 69.1%, and the prevalence of multimorbidity decreased from 47.1% to 45.6%. This downward trend was concentrated in minor and moderate diseases, whereas the prevalence of many major chronic diseases rose, along with instances of extreme multimorbidity (≥ 8 conditions). Age- and sex-standardized resource intensity weights, which reflect relative expected costs associated with patient diagnostic profiles, increased 4.6%.

interpretationEvidence of an upward trend in the prevalence of chronic disease was mixed. However, the change in case mix toward more serious conditions, along with increasing patient resource intensity weights overall, may portend a future need for population health management and increased health system spending above that predicted by population aging.

Indexed as

AdolescentAdultAgedAged, 80 and overChildChild, PreschoolChronic DiseaseFemaleHumansInfantInfant, NewbornMaleMiddle AgedMultimorbidityOntarioPrevalence

Identifiers

PMID33619067
PMCPMC8034347
OpenAlexW3133465291

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.