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Rethinking morbidity compression

Authors: Alyson A. van Raalte; Rosie Seaman; Rosie Seaman; Kaare Christensen; Pekka Martikainen; Pekka Martikainen; Hohn Andreas; +3 Authors

Rethinking morbidity compression

Abstract

AbstractStudies of morbidity compression routinely report the average number of years spent in an unhealthy state but do not report variation in age at morbidity onset. Variation was highlighted by Fries (1980) as crucial for identifying disease postponement. Using incidence of first hospitalization after age 60, as one working example, we estimate variation in morbidity onset over a 27-year period in Denmark. Annual estimates of first hospitalization and the population at risk for 1987 to 2014 were identified using population-based registers. Sex-specific life tables were constructed, and the average age, the threshold age, and the coefficient of variation in age at first hospitalization were calculated. On average, first admissions lasting two or more days shifted towards older ages between 1987 and 2014. The average age at hospitalization increased from 67.8 years (95% CI 67.7–67.9) to 69.5 years (95% CI 69.4–69.6) in men, and 69.1 (95% CI 69.1–69.2) to 70.5 years (95% CI 70.4–70.6) in women. Variation in age at first admission increased slightly as the coefficient of variation increased from 9.1 (95% CI 9.0–9.1) to 9.9% (95% CI 9.8–10.0) among men, and from 10.3% (95% CI 10.2–10.4) to 10.6% (95% CI 10.5–10.6) among women. Our results suggest populations are ageing with better health today than in the past, but experience increasing diversity in healthy ageing. Pensions, social care, and health services will have to adapt to increasingly heterogeneous ageing populations, a phenomenon that average measures of morbidity do not capture.

Keywords

Morbidity compressin, Adult, Male, Aging, 330, Essay, Denmark [MeSH] ; Life Tables [MeSH] ; Essay ; Female [MeSH] ; Aged [MeSH] ; Hospitalization [MeSH] ; Adult [MeSH] ; Ageing and health ; Humans [MeSH] ; Aging [MeSH] ; Incidence [MeSH] ; Middle Aged [MeSH] ; Age at morbidity onset ; Male [MeSH] ; Life Expectancy [MeSH] ; Morbidity [MeSH] ; Morbidity compression ; Hospital admission, Denmark, 610, Life Expectancy, Sociology, Humans, Life Tables, Age at morbidity onset, Aged, Incidence, 3rd-DAS, Ageing and health, Middle Aged, Hospital admission, Hospitalization, Morbidity compression, RA Public aspects of medicine, Female, Morbidity, RA

  • BIP!
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    citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
12
Top 10%
Average
Top 10%
Green
hybrid