Increasing age- and gender-specific burden and complexity of multimorbidity in Taiwan, 2003–2013: a cross-sectional study based on nationwide claims data

Abstract

ObjectiveAlthough there is accumulating evidence regarding multimorbidity in Western countries, this information is very limited in Asian countries. This study aimed to estimate population-based, age-specific and gender-specific prevalence and trends of multimorbidity in the Taiwanese population.DesignThis was a cross-sectional study based on claims data (National Health Insurance Research Database, Taiwan).ParticipantsThe participants included a subset of the National Health Insurance Research Database, which contains claims data for two million randomly selected beneficiaries (~10% of the total population) under Taiwan’s mandatory National Health Insurance system.Outcome measurementsThe prevalence of multimorbidity in different age groups and in both sexes in 2003 and 2013 was reported. We analysed data on the prevalence of 20 common diseases in each age group and for both sexes. To investigate the clustering effect, we used graphical displays to analyse the likelihood of co-occurrence with one, two, three, and four or more other diseases for each selected disease in 2003 and 2013.ResultsThe prevalence of multimorbidity (two or more diseases) was 20.07% in 2003 and 30.44% in 2013. In 2013, the prevalence varied between 5.21% in patients aged 20–29 years and 80.96% in those aged 80–89 years. In patients aged 50–79 years, the prevalence of multimorbidity was higher in women than in men. In men, the prevalence of chronic pulmonary disease and cardiovascular-related diseases was predominant, while in women the prevalence of osteoporosis, arthritis, cancer and psychosomatic disorders was predominant. Co-occurring diseases varied across different age and gender groups.ConclusionsThe burden of multimorbidity is increasing and becoming more complex in Taiwan, and it was found to vary across different age and gender groups. Fulfilling the needs of individuals with multimorbidity requires collaborative work between healthcare providers and needs to take the age and gender disparities of multimorbidity into account.

Estimating and characterizing the burden of multimorbidity in the community: A comprehensive multistep analysis of two large nationwide representative surveys in France

“…in this country [29], while estimates of the prevalence of multimorbidity and specific multimorbid combinations as well as the observed higher prevalence among women are in line with other studies conducted in Europe [5,8] and worldwide [7]. Our study strongly confirms that multimorbidity is not just a problem of old age [30][31][32][33]: In middle age (35 to 54 years), it affects 1 in 6 men and 1 in 4 women. This study also found marked socioeconomic gradients, with participants, especially women, with lower education and socioeconomic status exhibiting higher multimorbidity rates earlier in the life, as already observed [5,34].…”

Relationship of Multimorbidity, Obesity Status, and Grip Strength among Older Adults in Taiwan

“…In the United States, three in four adults over age 65 have multimorbidity [ 2 , 3 ]. In Taiwan, the prevalence of multimorbidity was around four in five people above 80 [ 4 ]. Meanwhile, the ageing population increased significantly because of fertility decline and added residual life.…”

“…Meanwhile, the ageing population increased significantly because of fertility decline and added residual life. The condition of multimorbidity also grows with ageing, and it is associated with an increased burden on healthcare costs [ 4 , 5 ]. Multimorbidity among older adults indicates a serious and crucial challenge not only for patient care but also for the healthcare systems in modern countries.…”

Multimorbidity Analysis of 13 Systemic Diseases in Northeast China

“…A person with numerous long-term health conditions has an increased risk of depression, hospitalizations, polypharmacy, loss of physical functioning, and even premature death [5,6]. In addition, multimorbidity places a substantial economic burden on the healthcare system [7][8][9][10], especially in the world's most populous country, China [11,12], because patients with multimorbidity often require additional intensive treatment and monitoring by nurses, physicians and other healthcare staff [13,14]. Therefore, the identification of the key determinants of multimorbidity is an important public health aim that should be addressed urgently.…”