Skip to main content
PMC home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1986 Oct;145(4):537–545.

Chronic Disease in a General Adult Population

Findings From the Rand Health Insurance Experiment

Kathleen N Lohr 1,2,3,4,5,6,7,8, Caren J Kamberg 1,2,3,4,5,6,7,8, George A Goldberg 1,2,3,4,5,6,7,8, Robert H Brook 1,2,3,4,5,6,7,8, Emmett B Keeler 1,2,3,4,5,6,7,8, Thomas A Calabro 1,2,3,4,5,6,7,8
PMCID: PMC1307010  PMID: 3788141

Abstract

Using questionnaire and physical screening examination data for a general population of 4,962 adults aged 18 to 61 years enrolled in the Rand Health Insurance Experiment, we calculated the prevalence of 13 chronic illnesses and assessed disease impact. Low-income men had a significantly higher prevalence of anemia, chronic airway disease and hearing impairment than their high-income counterparts, low-income women a higher prevalence of congestive heart failure, diabetes mellitus, hypertension, hearing impairment and vision impairment. Of our sample, 30% had one chronic condition and 16% had two or more. Several significant pairs or “clusters” of chronic illnesses were found. With few exceptions (diabetes, hypertension), the use of physician care in the previous year for a specific condition tended to be low. Disease impact (worry, activity restriction) was widespread but mild. Persons with angina, congestive heart failure, mild chronic joint disorders and peptic ulcer disease reported a greater impact than persons with other illnesses.

Full text

PDF
538

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abramson J. H., Gofin J., Peritz E., Hopp C., Epstein L. M. Clustering of chronic disorders--a community study of coprevalence in Jerusalem. J Chronic Dis. 1982;35(3):221–230. doi: 10.1016/0021-9681(82)90143-6. [DOI] [PubMed] [Google Scholar]
  2. Bracht N. F. The social nature of chronic disease and disability. Soc Work Health Care. 1979 Winter;5(2):129–144. doi: 10.1300/j010v05n02_02. [DOI] [PubMed] [Google Scholar]
  3. Brook R. H., Ware J. E., Jr, Rogers W. H., Keeler E. B., Davies A. R., Donald C. A., Goldberg G. A., Lohr K. N., Masthay P. C., Newhouse J. P. Does free care improve adults' health? Results from a randomized controlled trial. N Engl J Med. 1983 Dec 8;309(23):1426–1434. doi: 10.1056/NEJM198312083092305. [DOI] [PubMed] [Google Scholar]
  4. Cleary P. D., Jette A. M. The validity of self-reported physician utilization measures. Med Care. 1984 Sep;22(9):796–803. doi: 10.1097/00005650-198409000-00003. [DOI] [PubMed] [Google Scholar]
  5. Cluff L. E. Chronic disease, function and the quality of care. J Chronic Dis. 1981;34(7):299–304. doi: 10.1016/0021-9681(81)90067-9. [DOI] [PubMed] [Google Scholar]
  6. Cooper B. S., Rice D. P. The economic cost of illness revisited. Soc Secur Bull. 1976 Feb;39(2):21–36. [PubMed] [Google Scholar]
  7. Cummings K. M., Kirscht J. P., Becker M. H., Levin N. W. Construct validity comparisons of three methods for measuring patient compliance. Health Serv Res. 1984 Apr;19(1):103–116. [PMC free article] [PubMed] [Google Scholar]
  8. Hartunian N. S., Smart C. N., Thompson M. S. The incidence and economic costs of cancer, motor vehicle injuries, coronary heart disease, and stroke: a comparative analysis. Am J Public Health. 1980 Dec;70(12):1249–1260. doi: 10.2105/ajph.70.12.1249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Inui T. S., Carter W. B., Pecoraro R. E., Pearlman R. A., Dohan J. J. Variations in patient compliance with common long-term drugs. Med Care. 1980 Oct;18(10):986–993. doi: 10.1097/00005650-198010000-00002. [DOI] [PubMed] [Google Scholar]
  10. Manton K. G., Liu K. Projecting chronic disease prevalence. Med Care. 1984 Jun;22(6):511–526. doi: 10.1097/00005650-198406000-00002. [DOI] [PubMed] [Google Scholar]
  11. Manton K. G., Stallard E. Mortality of the chronically impaired. Demography. 1980 May;17(2):189–206. [PubMed] [Google Scholar]
  12. Meenan R. F., Yelin E. H., Nevitt M., Epstein W. V. The impact of chronic disease: a sociomedical profile of rheumatoid arthritis. Arthritis Rheum. 1981 Mar;24(3):544–549. doi: 10.1002/art.1780240315. [DOI] [PubMed] [Google Scholar]
  13. Newhouse J. P., Manning W. G., Morris C. N., Orr L. L., Duan N., Keeler E. B., Leibowitz A., Marquis K. H., Marquis M. S., Phelps C. E. Some interim results from a controlled trial of cost sharing in health insurance. N Engl J Med. 1981 Dec 17;305(25):1501–1507. doi: 10.1056/NEJM198112173052504. [DOI] [PubMed] [Google Scholar]
  14. Yelin E. H., Feshbach D. M., Meenan R. F., Epstein W. V. Social problems, services and policy for persons with chronic disease: the case of rheumatoid arthritis. Soc Sci Med Med Econ. 1979 Mar;13C(1):13–20. doi: 10.1016/0160-7995(79)90021-2. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES