How many people have multiple conditions?

Nearly one in four people in our sample had 2+ conditions (Figure 1), which corresponds to an estimated 14.2 million people in England., Around one in 12 people have 4+ conditions – an estimated 4.7 million people in England.

Figure 1: Percentage of people with 0, 1, 2, 3 and 4+ conditions

The most common conditions in our sample are shown in Figure 2. One in seven people had hypertension and one in eight had a painful condition. A person with hypertension had an average of 2.1 additional conditions and a person with depression or anxiety had 2.0 additional conditions. People with chronic kidney disease had 3.3 additional conditions.

There has been some interest in identifying clusters and combinations of multiple conditions that are associated with particularly poor outcomes for patients and increased demand on the health care system. Of the 36 conditions we included, some fall within the same body system – for example, coronary heart disease and hypertension. These might share underlying biological mechanisms and as a result there might be a common treatment approach. By contrast, conditions that are in different body systems, and treated by different specialists may be more complex to manage (eg depression and diabetes). An important limitation of our work is that we counted each condition as separate, even if it was related to another, and did not account for whether any might be concordant or discordant. Future work to describe the impact on people and on the NHS of having multiple discordant versus concordant conditions could help the NHS to plan services better.

Figure 2: Common conditions and average number of additional conditions

* This is an estimate is based on September 2018 figures of 59,297,331 patients registered at a GP practice in England. It is based on the estimated prevalence of 2+ conditions in each year of age but does not account for other characteristics that might be related to prevalence (eg gender, socioeconomic deprivation).

People on 4+ prescription-only analgesics or 4 antiepileptics in the absence of an epilepsy diagnosis were defined as having a painful condition.

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