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Prevalence and overlap of Disease Management Program diseases in older hospitalized patients

Author

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  • Helle Gybel Juul-Larsen

    (University of Copenhagen
    University of Copenhagen)

  • Janne Petersen

    (University of Copenhagen
    University of Copenhagen)

  • Ditte Maria Sivertsen

    (University of Copenhagen)

  • Ove Andersen

    (University of Copenhagen)

Abstract

Many countries, like Denmark, have tailored Disease Management Programs (DMPs) based on patients having single chronic diseases [defined institutionally as “program diseases” (PDs)], which can complicate treatment for those with multiple chronic diseases. The aims of this study were (a) to assess the prevalence and overlap among acutely hospitalized older medical patients of PDs defined by the DMPs, and (b) to examine transitions between different departments during hospitalization and mortality and readmission within two time intervals among patients with the different PDs. We conducted a registry study of 4649 acutely hospitalized medical patients ≥65 years admitted to Copenhagen University Hospital, Hvidovre, Denmark, in 2012, and divided patients into six PD groups (type 2 diabetes, chronic obstructive pulmonary disease, cardiovascular disease, musculoskeletal disease, dementia and cancer), each defined by several ICD-10 codes predefined in the DMPs. Of these patients, 904 (19.4%) had 2 + PDs, and there were 47 different combinations of the six different PDs. The most prevalent pair of PDs was type 2 diabetes with cardiovascular disease in 203 (22.5%) patients, of whom 40.4% had an additional PD. The range of the cumulative incidence of being readmitted within 90 days was between 28.8% for patients without a PD and 46.6% for patients with more than one PD. PDs overlapped in many combinations, and all patients had a high probability of being readmitted. Hence, developing strategies to create a new generation of DMPs applicable to older patients with comorbidities could help clinicians organize treatment across DMPs.

Suggested Citation

  • Helle Gybel Juul-Larsen & Janne Petersen & Ditte Maria Sivertsen & Ove Andersen, 2017. "Prevalence and overlap of Disease Management Program diseases in older hospitalized patients," European Journal of Ageing, Springer, vol. 14(3), pages 283-293, September.
    • Handle: RePEc:spr:eujoag:v:14:y:2017:i:3:d:10.1007_s10433-017-0412-9
    DOI: 10.1007/s10433-017-0412-9
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    References listed on IDEAS

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    1. Inge Kirchberger & Christa Meisinger & Margit Heier & Anja-Kerstin Zimmermann & Barbara Thorand & Christine S Autenrieth & Annette Peters & Karl-Heinz Ladwig & Angela Döring, 2012. "Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-7, January.
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