Quantifying the impact of multiple health conditions

Individually, cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD) are serious illnesses that contribute significantly to deaths and levels of ill health in the Australian population. When they occur together, the negative effects on health status and health services go beyond the sum of the effects of each single disease.

A new report released today by the Australian Institute of Health and Welfare (AIHW) is the first of its kind to examine in depth, the number of people in Australia with two or more of these conditions and to quantify associated rates of hospitalisation and mortality.

The report, Comorbidity of cardiovascular disease, diabetes and chronic kidney disease in Australia, found that an estimated 26% of adults living in the community have either cardiovascular disease (CVD) or diabetes. About 1% of people under the age of 45, and about 10% of people 65 and older, have both diseases.

'Among people with diabetes, it is estimated that 60% to 70% had at least one form of CVD and that cardiovascular disease was a contributing factor in over 65% of hospitalisations and nearly 84% of deaths, ' said Lynelle Moon, Head of the Institute's Cardiovascular Disease and Diabetes Unit.

Among people in hospital with chronic kidney disease (not counting day-stay hospital admissions for dialysis) nearly 70% had at least one form of CVD recorded. CVD also contributed to about 76% of deaths among people with chronic kidney disease.

Concurrent conditions of two or three of these diseases were recorded as causes of death for 17,239 (13.2%) people who died in 2004.

In total, 62% of deaths in 2004 were associated with at least one of these conditions.

Comorbidity of CVD, diabetes and chronic kidney disease is mainly caused by complex interrelationships between these conditions and shared risk factors such as physical inactivity, poor nutrition and obesity.

'Because of these associations, there is the potential to reduce the associated burden by controlling common risk factors and improving disease management, Ms Moon said.

As these comorbidities mainly affect older people, the number of people with multiple chronic conditions is expected to increase as the Australian population ages.

An increase in the number of people with comorbidity naturally is likely to increase the demands on health services, including greater use of services, more visits to doctors, longer consultation times, more hospital admissions and longer stays.

The report is the first in a planned series that will examine other characteristics of these comorbidities.


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