Multiple chronic conditions and life expectancy

a life table analysis

Eva H DuGoff, Vladimir Canudas-Romo, Christine Buttorff, Bruce Leff, Gerard F Anderson

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy.

OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions.

RESEARCH DESIGN: A retrospective cohort study using single-decrement period life tables.

SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008.

MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer, chronic obstructive pulmonary disease, stroke, and Alzheimer disease), and number of comorbid conditions. Comorbidity was measured as a count of conditions collected by Chronic Conditions Warehouse and the Charlson Comorbidity Index.

RESULTS: Life expectancy decreases with each additional chronic condition. A 67-year-old individual with no chronic conditions will live on average 22.6 additional years. A 67-year-old individual with 5 chronic conditions and ≥10 chronic conditions will live 7.7 fewer years and 17.6 fewer years, respectively. The average marginal decline in life expectancy is 1.8 years with each additional chronic condition-ranging from 0.4 fewer years with the first condition to 2.6 fewer years with the sixth condition. These results are consistent by sex and race. We observe differences in life expectancy by selected conditions at 67, but these differences diminish with age and increasing numbers of comorbid conditions.

CONCLUSIONS: Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency.

Original languageEnglish
JournalMedical Care
Volume52
Issue number8
Pages (from-to)688-94
ISSN0025-7079
DOIs
Publication statusPublished - Aug 2014

Fingerprint

Life Expectancy
Comorbidity
Chronic Obstructive Pulmonary Disease
Alzheimer Disease
Cohort Studies
Retrospective Studies
Outcome Assessment (Health Care)

Cite this

DuGoff, E. H., Canudas-Romo, V., Buttorff, C., Leff, B., & Anderson, G. F. (2014). Multiple chronic conditions and life expectancy: a life table analysis. Medical Care, 52(8), 688-94. https://doi.org/10.1097/MLR.0000000000000166
DuGoff, Eva H ; Canudas-Romo, Vladimir ; Buttorff, Christine ; Leff, Bruce ; Anderson, Gerard F. / Multiple chronic conditions and life expectancy : a life table analysis. In: Medical Care. 2014 ; Vol. 52, No. 8. pp. 688-94.
@article{8695158aa7664740a7f2f02ca98dabf7,
title = "Multiple chronic conditions and life expectancy: a life table analysis",
abstract = "BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy.OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions.RESEARCH DESIGN: A retrospective cohort study using single-decrement period life tables.SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008.MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer, chronic obstructive pulmonary disease, stroke, and Alzheimer disease), and number of comorbid conditions. Comorbidity was measured as a count of conditions collected by Chronic Conditions Warehouse and the Charlson Comorbidity Index.RESULTS: Life expectancy decreases with each additional chronic condition. A 67-year-old individual with no chronic conditions will live on average 22.6 additional years. A 67-year-old individual with 5 chronic conditions and ≥10 chronic conditions will live 7.7 fewer years and 17.6 fewer years, respectively. The average marginal decline in life expectancy is 1.8 years with each additional chronic condition-ranging from 0.4 fewer years with the first condition to 2.6 fewer years with the sixth condition. These results are consistent by sex and race. We observe differences in life expectancy by selected conditions at 67, but these differences diminish with age and increasing numbers of comorbid conditions.CONCLUSIONS: Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency.",
author = "DuGoff, {Eva H} and Vladimir Canudas-Romo and Christine Buttorff and Bruce Leff and Anderson, {Gerard F}",
year = "2014",
month = "8",
doi = "10.1097/MLR.0000000000000166",
language = "English",
volume = "52",
pages = "688--94",
journal = "Medical Care",
issn = "0025-7079",
publisher = "Lippincott Williams & Wilkins",
number = "8",

}

DuGoff, EH, Canudas-Romo, V, Buttorff, C, Leff, B & Anderson, GF 2014, 'Multiple chronic conditions and life expectancy: a life table analysis', Medical Care, vol. 52, no. 8, pp. 688-94. https://doi.org/10.1097/MLR.0000000000000166

Multiple chronic conditions and life expectancy : a life table analysis. / DuGoff, Eva H; Canudas-Romo, Vladimir; Buttorff, Christine; Leff, Bruce; Anderson, Gerard F.

In: Medical Care, Vol. 52, No. 8, 08.2014, p. 688-94.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Multiple chronic conditions and life expectancy

T2 - a life table analysis

AU - DuGoff, Eva H

AU - Canudas-Romo, Vladimir

AU - Buttorff, Christine

AU - Leff, Bruce

AU - Anderson, Gerard F

PY - 2014/8

Y1 - 2014/8

N2 - BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy.OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions.RESEARCH DESIGN: A retrospective cohort study using single-decrement period life tables.SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008.MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer, chronic obstructive pulmonary disease, stroke, and Alzheimer disease), and number of comorbid conditions. Comorbidity was measured as a count of conditions collected by Chronic Conditions Warehouse and the Charlson Comorbidity Index.RESULTS: Life expectancy decreases with each additional chronic condition. A 67-year-old individual with no chronic conditions will live on average 22.6 additional years. A 67-year-old individual with 5 chronic conditions and ≥10 chronic conditions will live 7.7 fewer years and 17.6 fewer years, respectively. The average marginal decline in life expectancy is 1.8 years with each additional chronic condition-ranging from 0.4 fewer years with the first condition to 2.6 fewer years with the sixth condition. These results are consistent by sex and race. We observe differences in life expectancy by selected conditions at 67, but these differences diminish with age and increasing numbers of comorbid conditions.CONCLUSIONS: Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency.

AB - BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy.OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions.RESEARCH DESIGN: A retrospective cohort study using single-decrement period life tables.SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008.MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer, chronic obstructive pulmonary disease, stroke, and Alzheimer disease), and number of comorbid conditions. Comorbidity was measured as a count of conditions collected by Chronic Conditions Warehouse and the Charlson Comorbidity Index.RESULTS: Life expectancy decreases with each additional chronic condition. A 67-year-old individual with no chronic conditions will live on average 22.6 additional years. A 67-year-old individual with 5 chronic conditions and ≥10 chronic conditions will live 7.7 fewer years and 17.6 fewer years, respectively. The average marginal decline in life expectancy is 1.8 years with each additional chronic condition-ranging from 0.4 fewer years with the first condition to 2.6 fewer years with the sixth condition. These results are consistent by sex and race. We observe differences in life expectancy by selected conditions at 67, but these differences diminish with age and increasing numbers of comorbid conditions.CONCLUSIONS: Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency.

U2 - 10.1097/MLR.0000000000000166

DO - 10.1097/MLR.0000000000000166

M3 - Journal article

VL - 52

SP - 688

EP - 694

JO - Medical Care

JF - Medical Care

SN - 0025-7079

IS - 8

ER -

DuGoff EH, Canudas-Romo V, Buttorff C, Leff B, Anderson GF. Multiple chronic conditions and life expectancy: a life table analysis. Medical Care. 2014 Aug;52(8):688-94. https://doi.org/10.1097/MLR.0000000000000166