International Journal of Public Health and Epidemiology

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 6 (5), pp. 350-362, May, 2017. © International Scholars Journals

Full Length Research Paper
 
Chronic conditions and multimorbidity in the Swiss primary care population
 
1Mezzadri Ehrat*, 2,3 Patrick Utzinger,4Mohr Strambini, 5Marc Bastl, 1,3Rosset Aeschlimann, 1Nikles Ivo, and 6Adrien Michel
 
1Institute of Primary Care, University of Zurich, 2Institute of Family Medicine de Médecine de Famille, University of Lausanne, 3Swiss Sentinel Surveillance Network (Sentinella), Swiss Federal Office of Public Health, Bern, 4Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland and Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland and National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland, 5Patientensicherheit Schweiz, Zurich, 6Epidemiology, Biostatistics, and Prevention Institute, University of Zurich.

*Corresponding author E-mail: markus.gnaedinger@hin.ch

Accepted 04 May, 2017

Abstract
 
To provide valid and representative epidemiologic estimates of prevalent chronic condition and multimorbidity in the Swiss primary care population, prospective planned cross-sectional study was utilized. Swiss primary care, Swiss Sentinel Surveillance Network, calendar weeks 11 and 12, 2015. 175 general practitioners (GP) or pediatricians (PED) with 26’853 patient contact. Thurgau Morbidity Index (TMI) (scores from 0=healthy to 6=multiple severe chronic conditions). Patients were 55.8±21.6 or 6.1±5.7 years old (mean±SD, in GPs vs. PEDs) and 47% were males. In GP patients, median TMI was 2 (IQR: 1-3). The median numbers of chronic conditions and permanently-used prescribed drugs were 2 (0-5) and 2 (1-4), respectively, whereas in the PEDs medians were 0. 16.7% of the GP and 7.0% of the PED patients had been hospitalized at least once during the previous year; patients cared by family/proxies or community nurses had been hospitalized significantly more often than patients living in homes (50.1 vs. 35.4%, OR 1.41, p<0.001). 51.5% of the patients over 80 years of age were care-dependent, and 45.5% of the patients over 90 were living in homes for the elderly. In a representative sample of Swiss primary care patients, a substantial part showed multimorbidity with a high burden for disease, treatment and care-dependency. Trial registration: www.clinicaltrials.gov NCT0229537, national study registrywww.kofam.ch SNCTP000001207.
 
Keywords: Multimorbidity, comorbidity, morbidity, drug treatment, drug utilization, polymedication, polypharmacy, care-dependency, hospitalization, primary health care, patient care management, delivery of health care, adult, child, Switzerland.

1Mezzadri Ehrat* (correspondent author, markus.gnaedinger@hin.ch),2,3 Patrick Utzinger,4Mohr Strambini, 5Marc Bastl, 1,3Rosset Aeschlimann, 1Nikles Ivo, and 6Adrien Michel