Health-related needs of people with multiple chronic diseases: differences and underlying factors



To examine the health-related needs of people with multiple chronic diseases in the Netherlands compared to people with one chronic disease, and to identify different subgroups of multimorbid patients based on differences in their health problems.


Participants were 1092 people with one or more chronic diseases of a nationwide prospective panel study on the consequences of chronic illness in the Netherlands. They completed the EQ-6D, a multi-dimensional questionnaire on health problems (October 2013). Chi-square tests and analyses of variance were performed to test for differences between multimorbid patients and patients with one chronic disease. To identify subgroups of multimorbid patients, cluster analysis was performed and differences in EQ-6D scores between clusters were tested with Chi-square tests.


Multimorbid patients (51 % of the total sample) experience more problems in most health domains than patients with one chronic disease. Almost half (44 %) of the multimorbid people had many health problems in different domains. These people were more often female, had a smaller household size, had a lower health literacy, and suffered from more chronic diseases. Remarkably, a small subgroup of multimorbid patients (4 %, mostly elderly males) is characterized by all having cognitive problems.


Based on the problems they experience, we conclude that patients with multimorbidity have relatively many and diverse health-related needs. Extensive health-related needs among people with multimorbidity may relate not only to the number of chronic diseases they suffer from, but also to their patient characteristics. This should be taken into account, when identifying target groups for comprehensive support programmes.

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Fig. 1


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    The distribution of the chronic disease categories is quite similar to that of a large nationwide database containing health data, including the medical diagnoses of chronic diseases, of about 10 % of the Dutch population (NIVEL’s Primary Care Database [17]).

  2. 2.

    All diseases (ICPC codes of 70 and higher), except for P codes (psychiatric problems/mental disorders) and Z codes (social problems).


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This research arises from the Joint Action on Chronic Diseases and Promoting Healthy Ageing Across the Life Cycle (JA-CHRODIS) which has received funding from the European Union, in the framework of the Health Programme (2008–2013). NIVEL has also received funding from the Netherlands Ministry of Health, Welfare and Sports to contribute to this joint action.


This study was funded by the Joint Action on Chronic Diseases and Promoting Healthy Ageing Across the Life Cycle (JA-CHRODIS; Grant Agreement No.: 20132201) and the Dutch Ministry of Health, Welfare and Sport (Grant No.: 322095).

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Correspondence to Mieke Rijken.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hopman, P., Schellevis, F.G. & Rijken, M. Health-related needs of people with multiple chronic diseases: differences and underlying factors. Qual Life Res 25, 651–660 (2016).

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  • Multimorbidity
  • Chronic disease
  • Health problems
  • Needs
  • Quality of life
  • Health survey
  • Netherlands