Preventing Chronic Disease Dialogue

The Preventing Chronic Disease journal welcomes comments from readers on selected published articles to encourage dialogue between chronic disease prevention, researchers, practitioners and advocates.

The Dimensions of Multiple Chronic Conditions: Where Do We Go From Here? A Commentary on the Special Collection of Preventing Chronic Disease

May 3rd, 2013 9:02 am ET -

EDITORIAL

Robert B. Wallace, MD, MsC; Marcel E. Salive, MD, MPH

Suggested citation for this article: Wallace RB, Salive ME. The Dimensions of Multiple Chronic Conditions: Where Do We Go From Here? A Commentary on the Special Collection of Preventing Chronic Disease. Prev Chronic Dis 2013;10:130104. DOI: http://dx.doi.org/10.5888/pcd10.130104

The articles in this issue address the high prevalence and substantial clinical burden of multiple chronic conditions (MCC) among adults. All of these papers further the goals outlined in the US Department of Health and Human Services (DHHS) MCC Strategic Framework (1,2). The article by Goodman, Posner, Huang, Parekh, and Koh (3) introduces the topic and describes the origin of the 20 conditions originally selected by the DHHS for emphasis. The authors also provide a conceptual model for standardizing data approaches to the analyses of MCC. The remaining articles document various distributions and rates of MCC on the national level with analyses of important federal health surveys and databases: Lochner and Cox analyzed Medicare claims data (4); Ashman and Beresovsky analyzed 1 year of the National Ambulatory Medical Care Survey (5); Ford, Croft, Posner, Goodman, and Giles explored the prevalence of lifestyle-related MCC from the National Health Interview Survey (6); Steiner and Friedman examined MCC-related acute care hospitalization rates from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project (7); Soni and Machlin analyzed the costs of certain MCC from the Medical Expenditure Panel Survey (8), and Ward and Schiller estimated MCC rates from the National Health Interview Survey (9).
Each of these articles explores different data sources, and despite the variation in disease and condition combinations selected, these articles show the ability of many US federal datasets to address and better characterize the scope of MCC as well as incorporate important MCC-related issues such as the effect of MCC on the cost of clinical care and the extent of clinical care use. Collecting data from multiple sources, including population surveys and claims data, and from both institutional settings and ambulatory primary care allows triangulation and better comprehension of this issue. Although the challenges of the complex MCC patient have long been recognized, these articles highlight national prevalence rates and implications for prevention, diagnosis, management, and important outcomes. Here we suggest some directions for addressing MCC in the future and offer suggestions on how to address this complexity on the basis of the work presented in this collection and the growing body of emerging information on MCC.