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

Mitch Steffler, Yin Li, Sharada Weir, Shaun Shaikh, Farshad Murtada, James G. Wright and Jasmin Kantarevic
CMAJ February 22, 2021 193 (8) E270-E277; DOI: https://doi.org/10.1503/cmaj.201473
Mitch Steffler
Economics, 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
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Yin Li
Economics, 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
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Sharada Weir
Economics, 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
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Shaun Shaikh
Economics, 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
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Farshad Murtada
Economics, 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
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James G. Wright
Economics, 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
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Jasmin Kantarevic
Economics, 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
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    Figure 1:

    Number of patients with chronic conditions in Ontario from fiscal years 2008 to 2017. Note: M = millions.

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    Figure 2:

    Five-year prevalence of 85 chronic conditions (fiscal year 2008 v. 2017) by age group. Note: Prevalence in both fiscal years was standardized to the 2017 population.

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    Figure 3:

    Age- and sex-standardized 5-year prevalence of ≥ 1 chronic conditions by category (fiscal year 2008 v. 2017). Note: Eighty-five conditions were classified based on type and severity into existing Canadian Institute for Health Information clinical categories (Appendix 2, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.201473/tab-related-content). Prevalence in both fiscal years was standardized to the 2017 population.

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    Figure 4:

    Change in age- and sex-standardized 5-year prevalence of major chronic and major mental health conditions (fiscal year 2008 v. 2017). The change is expressed as the relative prevalence in 2017 compared with 2008, where the prevalence in 2008 is equal to 100%. DM = diabetes mellitus, Dx = diagnosis, HCC = health condition code, PVD = peripheral vascular disease. Note: “No DM” indicates diabetes mellitus and hypoglycemia have not been diagnosed.

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    Figure 5:

    Age- and sex-standardized concurrent resource intensity weights (RIWs) from 2008 to 2017, by risk threshold (i.e., expected resource use percentiles selected to highlight patients in the top 10%, 5% and 1% of RIWs). Note: RIW is a measure of expected relative resource utilization based on a patient’s diagnostic history and is an output of the Canadian Institute for Health Information’s Population Grouping Methodology (Appendix 3, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.201473/tab-related-content).

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    Table 1:

    Age- and sex-standardized prevalence of number of chronic disease conditions in Ontario, fiscal year 2008 versus 2017

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Canadian Medical Association Journal: 193 (8)
CMAJ
Vol. 193, Issue 8
22 Feb 2021
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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
CMAJ Feb 2021, 193 (8) E270-E277; DOI: 10.1503/cmaj.201473

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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
CMAJ Feb 2021, 193 (8) E270-E277; DOI: 10.1503/cmaj.201473
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