When the days get shorter, everyone starts coughing and sniffling again. People are more susceptible to diseases and end up in hospital more often. The pressure on health care increases considerably in the winter. Certain combinations of chronic conditions play a crucial role in this.
Comorbidity – or the presence of a second condition in addition to a primary disease – accounts for much of the additional pressure the healthcare system faces each winter. This is because comorbidity is strongly linked to increased risks of hospitalization and death, British scientists write. For example, the study shows that people with a combination of cancer, kidney disease, cardiovascular disease and type 2 diabetes are eleven times more likely to be hospitalized than people without these conditions. In addition, it turned out that people with a combination of kidney disease, cardiovascular disease, dementia and osteoarthritis are no less than 24 times more likely to die.
‘Winter pressure’ due to cold
The ‘winter pressure period’ is approaching again. This runs approximately from December 1 to March 31. The increased pressure on healthcare during this period arises because patients’ health problems are exacerbated by the cold, seasonal viruses and increasing loneliness. In addition, the occupancy rate of hospital beds is much higher and absenteeism due to illness among healthcare staff is increasing significantly.
By 2035, it is expected that almost 70 percent of the English population will suffer from two or more chronic conditions. Although previous research has linked the increased pressure on the healthcare system to multiple chronic conditions during winter, it has until now been unclear which specific combinations pose the greatest burden on the system. Therefore, the researchers decided to look for primary and secondary healthcare data for adults in England during the winter pressure period of 2021-2022. This period coincided with the corona pandemic, which obviously seriously disrupted healthcare provision.
Huge database
The study used data from 48.3 million people with an average age of 49 years. The researchers selected 59 chronic conditions, which were classified into 19 categories based on feedback from doctors, patients and policy makers.
A total of 4.7 million hospitalizations and 176,895 deaths occurred during the study period. Of the participants, 40.5 percent had no chronic conditions, 28 percent suffered from one condition, and almost a third (31 percent) had two or more. After adjusting for factors such as age, gender, ethnicity and socio-economic status, it turned out that people with cancer, kidney disease, cardiovascular disease and diabetes were eleven times more likely to end up in hospital during the winter period than people without these conditions.
The deadliest combinations of diseases
In the ten combinations that contributed most to hospital admissions, cardiovascular disease occurred nine times, chronic kidney disease eight times, and cancer six times. In the death category, it turned out that people with both cardiovascular disease and dementia died almost fifteen times as often as those without these conditions. And people with a combination of kidney disease, cardiovascular disease, dementia and osteoarthritis had 24 times the risk.
The researchers point out that cardiovascular disease occurs in all ten of the deadliest combinations, while kidney disease plays a role in seven of these combinations. The combination of cardiovascular disease plus dementia appears in the entire top five deadliest combinations and carries a significantly higher mortality risk than many triple, quadruple or fivefold combinations of conditions.
Recognizing patterns
“Multimorbidity patterns are an important factor in hospital admission and mortality during winter,” says researcher Jonathan Batty of the University of Leeds in an accompanying commentary. “It is important to look at the broader context of increasing winter pressure and multimorbidity in healthcare,” the researchers write. “This study underlines the need to develop methods to identify people at high risk of hospitalization and mortality. Then it is important to devise strategies to reduce the risk for those with the worst combinations.”
Winter Woes: Comorbidity and Healthcare Pressure
Ah, winter! That magical season where snowmen are made, hot chocolate is consumed in absurd quantities, and we all discover the simple joys of coughing up a lung. Truly, it’s the most wonderful time of the year… for viral infections! If you haven’t noticed, as the days get shorter and the temperatures drop, our immune systems seem to throw in the towel, waving a little white flag while suffering from the winter blues.
What’s the Problem?
Everyone seems to be fighting off something in winter, and hospitals are like busy nightclubs – packed to the brim, and filled with people who really didn’t want to be there in the first place. Apparently, this annual influx is partly due to a phenomenon called comorbidity. It’s like a party trick where, instead of pulling a rabbit out of a hat, you pull out multiple chronic conditions. And it turns out, this trick isn’t nearly as fun as it sounds!
According to those clever British scientists, if you’ve got a combo of conditions like cancer, kidney disease, cardiovascular disease, and type 2 diabetes, you’ve got about as much chance of avoiding a hospital bed as a penguin has of flying. A staggering eleven times more likely to be hospitalized! It’s like they’re handing out hospital admissions like party favors. And if that’s not enough, if you’re also juggling dementia and osteoarthritis with cardiovascular disease, your risk of kicking the bucket skyrockets to 24 times higher. Talk about a rough guest list!
The ‘Winter Pressure’ Period
Buckle up, folks, because from December 1 to March 31, we’re in what’s been dubbed the ‘winter pressure’ period. It’s when those pesky viruses come out to play, temperatures drop, and the loneliness of winter settles in like a heavy fog. Hospitals fill up quicker than an all-you-can-eat buffet, and healthcare staff call in sick like they’re competing in an Olympic sport. Honestly, it makes you wonder if winter should come with a health warning!
By 2035, roughly 70 percent of the English population could be steeped in two or more chronic conditions. So, if you thought it was tough to find a date in winter, just wait until you have to find a doctor who’s not swamped. It doesn’t take a genius to figure out that our healthcare system is headed for a busy time; it’s practically rolling out the red carpet for chaos!
What the Data Says
In an effort to shed some light on this dreary winter conundrum, a study took a deep dive into data from 48.3 million people. Yes, you read that right—48.3 million! That’s a bigger number than I can wrap my head around, and I’m a comedian! They analyzed 59 chronic conditions, filtering through a mountain of healthcare data as if it were a series of poorly hand-written love letters.
And what did they find? Oh, you know, just a casual 4.7 million hospitalizations and nearly 177,000 deaths during the study period. Of course, 40.5% of participants claimed they were entirely healthy—bless their hearts—while a good chunk had their very own chronic conditions that had decided to throw a pity party together. It turns out that cardiovascular disease showed up in nine out of the top ten reasons people were being admitted to the hospital. It’s like the chronic disease equivalent of the friend who never takes a hint and just keeps crashing your plans!
The Deadliest Combinations
Now, let’s get to the serious business. The study revealed the ten most notorious combinations of diseases, and who should feature but our old pal cardiovascular disease! This delightful condition danced its way through nine out of ten most dangerous combinations. If you’ve got cardiovascular disease and dementia—merry Christmas!—you’re almost fifteen times more likely to meet your maker than someone who’s keeping it simple with their health.
The researchers recommend that we pay attention to these somber patterns. They seem to think that if we can spot who’s really at risk, we can cook up some strategies to keep them out of the hospital. Because let’s face it, no one really wants to be there unless they’re looking for a downtrodden doctor who’s been surviving on vending machine snacks.
In Conclusion
In a nutshell, winter is coming (and so are the chronic conditions), and our healthcare system is prepping for a storm of sick people when it should be enjoying hot toddies by the fire. If you’re battling two or more chronic conditions, it might be time to brainstorm some strategies to hibernate until spring! And remember, laughter is the best medicine—so while the winter pressure mounts, let’s keep our spirits up and our coughs to ourselves!
Now, where’s my hot chocolate?
How can individuals proactively manage their health during the winter pressure period related to comorbidity?
**Winter Woes: An Interview on Comorbidity and Healthcare Pressure**
**Editor:** Today we’re sitting down with Dr. Jonathan Batty, a prominent researcher from the University of Leeds, who has been studying the impact of comorbidity on healthcare during the winter months. Dr. Batty, thank you for joining us.
**Dr. Batty:** Thank you for having me!
**Editor:** Let’s dive right into it. As we know, winter brings about a host of health challenges, and your research highlights the significant impact of comorbidity. Can you explain why this poses such a burden on the healthcare system during this season?
**Dr. Batty:** Absolutely. During winter, we see an increase in viruses and colder temperatures, which exacerbate existing health conditions. Comorbidity, or the presence of multiple chronic diseases in one patient, significantly raises the risk of hospitalization. For instance, those with conditions like cancer, cardiovascular diseases, and diabetes are eleven times more likely to end up in the hospital if they have these combined conditions.
**Editor:** That’s alarming! You also mentioned in your study that certain combinations of conditions are deadlier than others. Can you elaborate on that?
**Dr. Batty:** Yes, indeed. Our research found that combinations like cardiovascular disease and dementia can lead to death rates that are nearly fifteen times higher than for those without these conditions. Moreover, if someone has kidney disease alongside cardiovascular disease and dementia, their risk of mortality increases to 24 times, which is quite significant.
**Editor:** Wow, those numbers really put things into perspective. What do you think drives this increase in comorbidities among the population, especially as we look ahead to 2035?
**Dr. Batty:** A range of factors contributes to this. Aging is a significant element, as chronic conditions tend to accumulate over time. Additionally, lifestyle factors, socioeconomic challenges, and even access to healthcare play pivotal roles in this trend. By 2035, we’re expecting that a vast majority—almost 70 percent—of the English population will have two or more chronic conditions.
**Editor:** That’s a staggering prediction. What can healthcare providers and policymakers do to manage the ‘winter pressure’ period more effectively?
**Dr. Batty:** First, it’s essential to identify those at high risk of hospitalization and mortality based on their comorbidities. We need to develop strategies for early intervention, which can include better patient education, community support systems, and perhaps even targeted health campaigns during the winter months. Addressing loneliness, which often spikes in winter, could be impactful as well.
**Editor:** Those sound like proactive steps, indeed. Lastly, as individuals, what can we do to protect ourselves during this winter pressure period?
**Dr. Batty:** The best advice would be to maintain a healthy lifestyle, stay up to date with vaccinations, and not hesitate to seek help if you’re feeling unwell, particularly if you have existing chronic conditions. Building a support network can also provide emotional aid, which is crucial during the winter months.
**Editor:** Thank you, Dr. Batty, for shedding light on this important issue. Your insights are incredibly valuable, especially as we brace ourselves for another winter season.
**Dr. Batty:** Thank you for having me. Let’s hope for a healthier winter for everyone!
