The evolving chronic disease landscape: lessons for the post-pandemic world
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French National Public Health Agency, France
Western University, Canada
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1570
Background: The COVID-19 pandemic has had a major impact on people living with multiple chronic disease (multimorbidity), has reduced the ability to prevent disease via screening, has disrupted disease management, and has exacerbated health inequities. We propose a workshop to discuss the evolving chronic disease landscape, by providing three case-studies from diverse geographic locations, with a focus on multimorbidity, avoidable hospitalizations from chronic disease, and the role of social determinants of health. Objectives and key questions: Our objective is to discuss major public health challenges in chronic disease and lessons for the post-pandemic transition. Specifically, the workshop will address the following key questions: 1) what is the potential long-term impact of the pandemic among people living with multimorbidity? 2) what is the role of social determinants of health in avoidable hospitalizations from chronic disease? 3) how can we improve surveillance of multimorbidity using multiple data sources? Case study 1: multimorbidity and the risk of sars-cov-2 infection and post-covid-19 condition in France. Population data on SARS-COV-2 infection and its prolonged symptoms is limited among multimorbid patients. Here, we present the risks of SARS-COV-2 infection and post-COVID-19 condition, among individuals living with multimorbidity, using data from a large, randomly selected, representative sample of the adult French population. The interaction between multimorbidity and Covid-19 will be discussed. Case study 2: millions of hospital admissions are avoidable: the role of chronic conditions and social determinants of health in the United States. The rate of avoidable hospitalizations, for conditions that can be treated in primary care, is an important indicator of health system performance. We use the US National Inpatient Sample (2015-2020), to investigate the association between avoidable hospitalizations and chronic conditions, income, race and hospital region. Findings of this study can help develop targeted policies to improve primary care supply and quality to reduce avoidable hospitalizations from chronic conditions. Case study 3: surveillance of multimorbidity using multiple data sources: a Canadian perspective. Multimorbidity has been acknowledged as a burden for health care systems for many years, but the COVID-19 pandemic highlighted the fact that multimorbidity can result in a vulnerable general population. This study will present the epidemiology and surveillance of multimorbidity through the use of common operational definitions, a national health survey dataset (Canadian Longitudinal Study on Aging) and a national electronic medical record dataset (Canadian Primary Care Sentinel Surveillance Network). These findings will be compared to international literature and approaches to supporting individuals living with multimorbidity will be highlighted.  
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