{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T23:18:54Z","timestamp":1768000734791,"version":"3.49.0"},"reference-count":30,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministero dell'Istruzione, dell'Universit\u00e0 e della Ricerca","award":["20177BR-JXS"],"award-info":[{"award-number":["20177BR-JXS"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,5,3]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To find a definition of chronic disease based on literature review and to estimate the population-based prevalence rate of chronicity in a province in Northern Italy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective observational study based on administrative databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources\/setting<\/jats:title>\n                    <jats:p>Archives of the National Health Service that contain demographic and administrative information linked with the archives of ticket exemptions (2000\u20132019), the hospital discharge and drug prescriptions (2016\u20132019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Subjects who lived in Vercelli Local Health Authority, a Northern Italian province (Piedmont region), and were alive in December 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Prevalence of subjects with at least one chronic disease identified by administrative sources and stratification of population according to the number of comorbidities. The pathologies considered were: chronic ischaemic heart disease, congestive heart failure, cardiac arrhythmias, hypertension, stroke, neoplasm, asthma, chronic obstructive pulmonary disease, diabetes, thyroid disorders, osteoporosis, rheumatoid arthritis, chronic kidney disease, dementia, autism spectrum disorder, depression, schizophrenia, hepatitis, HIV and substance use disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our target population was about 164 344 subjects. The overall prevalence of subjects with at least one chronic condition was 21.43% (n=35 212): 19 541 were female and 15 671 were male with a raw prevalence of 22.96% and 19.77%, respectively. The overall prevalence increases with age until 85 years old, then a decrease is observed. Moreover, 16.39% had only one pathology, 4.30% two diseases and 0.74% had a more complex clinical condition (more than three diseases).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the difficulty of having a unique definition of chronic disease, the prevalence obtained was coherent with the estimates reported by other national surveillance systems such as Passi and Passi d\u2019Argento. Underestimates were observed when international comparisons were done; however, when we used less stringent definitions of chronic diseases, similar results were obtained.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-070820","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T10:15:23Z","timestamp":1687169723000},"page":"e070820","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Estimate of the prevalence of subjects with chronic diseases in a province of Northern Italy: a retrospective study based on administrative databases"],"prefix":"10.1136","volume":"13","author":[{"given":"Chiara","family":"Airoldi","sequence":"first","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9058-8535","authenticated-orcid":false,"given":"Federico","family":"Pagnoni","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiziana","family":"Cena","sequence":"additional","affiliation":[{"name":"Epidemiologic Unit of the Local Health Authority of Vercelli, Osservatorio Epidemiologico ASL, Vercelli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Ceriotti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damiano","family":"De Ambrosi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"De Vito","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Faggiano","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"2025120521254213000_13.6.e070820.1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1069675"},{"key":"2025120521254213000_13.6.e070820.2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-5_Part_2-200309021-00015"},{"key":"2025120521254213000_13.6.e070820.3","unstructured":"World Health Organization . Noncommunicable diseases. Geneva, 2021. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/noncommunicable-diseases"},{"key":"2025120521254213000_13.6.e070820.4","unstructured":"World Health Organization . Noncommunicable diseases progress monitor, 2017. Geneva, 2017."},{"key":"2025120521254213000_13.6.e070820.5","unstructured":"Institute for Health Metrics and Evaluation (IHME) . GBD Compare [Internet]. Seattle, WA: IHME, University of Washington, 2015. Available: https:\/\/vizhub.healthdata.org\/gbd-compare\/"},{"key":"2025120521254213000_13.6.e070820.6","unstructured":"Istituto Nazionale di Statistica . Popolazione e famiglie. Istituto Nazionale di Statistica, 2015. Available: https:\/\/www4.istat.it\/it\/anziani\/popolazione-e-famiglie"},{"key":"2025120521254213000_13.6.e070820.7","unstructured":"The European House-Ambrosetti S.p.A, The European House-Ambrosetti S.p.Ar . Le coordinate della salute [Internet]. Milan, 2020. Available: https:\/\/eventi.ambrosetti.eu\/meridiano-sanita-15\/wp-content\/uploads\/sites\/141\/2020\/11\/3.ReportMS15.pdf"},{"key":"2025120521254213000_13.6.e070820.8","unstructured":"World Health Organization . Global status report on noncommunicable diseases 2014. Geneva, 2014. Available: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/148114\/9789241564854_eng.pdf"},{"key":"2025120521254213000_13.6.e070820.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-015-1733-2","article-title":"The increasing burden and complexity of Multimorbidity","volume":"15","author":"Pefoyo","year":"2015","journal-title":"BMC Public Health"},{"key":"2025120521254213000_13.6.e070820.10","doi-asserted-by":"crossref","DOI":"10.5888\/pcd10.120239","article-title":"Defining and measuring chronic conditions: Imperatives for research, policy, program, and practice","volume":"10","author":"Goodman","year":"2013","journal-title":"Prev Chronic Dis"},{"key":"2025120521254213000_13.6.e070820.11","doi-asserted-by":"publisher","DOI":"10.5034\/inquiryjrnl_45.04.408"},{"key":"2025120521254213000_13.6.e070820.12","doi-asserted-by":"crossref","DOI":"10.1177\/26335565211028157","article-title":"Examine the association between key determinants identified by the chronic disease indicator framework and Multimorbidity by rural and urban settings","volume":"11","author":"Moin","year":"2021","journal-title":"J Multimorb Comorb"},{"key":"2025120521254213000_13.6.e070820.13","unstructured":"Ministero della Salute . Esenzioni per malattie croniche [Internet]. Rome: Ministero della Salute, 2017. Available: https:\/\/www.salute.gov.it\/portale\/esenzioni\/dettaglioContenutiEsenzioni.jsp?lingua=italiano&id=1017&area=esenzioni&menu=vuoto"},{"key":"2025120521254213000_13.6.e070820.14","unstructured":"Ministero della Salute . Elenco sistematico delle malattie [Internet]. Rome, 2009. Available: https:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_2251_ulterioriallegati_ulterioreallegato_2_alleg.pdf"},{"key":"2025120521254213000_13.6.e070820.15","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-11-688","article-title":"Can we use the pharmacy data to estimate the prevalence of chronic conditions? a comparison of multiple data sources","volume":"11","author":"Chini","year":"2011","journal-title":"BMC Public Health"},{"key":"2025120521254213000_13.6.e070820.16","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1002\/ejhf.471","article-title":"The real-world evidence of heart failure: findings from 41 413 patients of the ARNO database","volume":"18","author":"Maggioni","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2025120521254213000_13.6.e070820.17","first-page":"385","article-title":"Prevalence and clustering of chronic diseases in Tuscany (central Italy): evidence from a large administrative data warehouse","volume":"44","author":"Profili","year":"2020","journal-title":"Epidemiol Prev"},{"key":"2025120521254213000_13.6.e070820.18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0188377","article-title":"Monitoring compliance with standards of care for chronic diseases using Healthcare administrative databases in Italy: strengths and limitations","volume":"12","author":"Gini","year":"2017","journal-title":"PLoS One"},{"key":"2025120521254213000_13.6.e070820.19","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-017-1011-0"},{"key":"2025120521254213000_13.6.e070820.20","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/j.1755-5922.2009.00087.x","article-title":"Secondary prevention in concurrent coronary artery, cerebrovascular, and chronic kidney disease: focus on pharmacological therapy","volume":"27","author":"Notaro","year":"2009","journal-title":"Cardiovasc Ther"},{"key":"2025120521254213000_13.6.e070820.21","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12890-016-0362-6","article-title":"Can Healthcare utilization data reliably capture cases of chronic respiratory diseases? a cross-sectional investigation in Italy","volume":"17","author":"Biffi","year":"2017","journal-title":"BMC Pulm Med"},{"key":"2025120521254213000_13.6.e070820.22","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/6017165","article-title":"The prevalence of fragility fractures in a population of a region of Southern Italy affected by thyroid disorders","volume":"2016","author":"Maccagnano","year":"2016","journal-title":"Biomed Res Int"},{"key":"2025120521254213000_13.6.e070820.23","unstructured":"West SL , Garbutt JC , Carey TS , et al . Pharmacotherapy for alcohol dependence. Evid Rep Technol Assess (Summ) 1999:1\u20135."},{"key":"2025120521254213000_13.6.e070820.24","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2016-000197","article-title":"Economic aspects in the management of diabetes in Italy","volume":"4","author":"Marcellusi","year":"2016","journal-title":"BMJ Open Diabetes Res Care"},{"key":"2025120521254213000_13.6.e070820.25","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.numecd.2016.05.002","article-title":"The relative burden of diabetes complications on Healthcare costs: the population-based CINECA-SID ARNO diabetes Observatory","volume":"26","author":"Pagano","year":"2016","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2025120521254213000_13.6.e070820.26","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1080\/19371918.2013.759031","article-title":"Medications for substance use disorders","volume":"28","author":"Douaihy","year":"2013","journal-title":"Soc Work Public Health"},{"key":"2025120521254213000_13.6.e070820.27","doi-asserted-by":"publisher","DOI":"10.1097\/mlr.0000000000000166"},{"key":"2025120521254213000_13.6.e070820.28","unstructured":"Istituto Superiore di Sanit\u00e0 . Sorveglianza PASSI [Internet]. Rome, 2013. Available: https:\/\/www.epicentro.iss.it\/passi\/dati\/croniche"},{"key":"2025120521254213000_13.6.e070820.29","unstructured":"Istituto Superiore di sanit\u00e0 . Sorveglianza Passi d\u2019Argento. Rome: Istituto Superiore di Sanit\u00e0, 2014. Available: https:\/\/www.epicentro.iss.it\/passi-argento\/dati\/croniche"},{"key":"2025120521254213000_13.6.e070820.30","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60240-2"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-070820","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:25:49Z","timestamp":1764998749000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-070820"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6,19]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/bmjopen-2022-070820"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-070820","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}