Research Seminar: 'Comorbidity and Adapting to Chronic Conditions in Russia’
On Monday, 5th June, the International Centre for Health Economics, Management, and Policy (CHEMP) at HSE, St. Petersburg held another one of its signature research seminar series. Maria Kaneva, a senior research fellow at the International Centre for Economics of Healthcare and Its Reforms at the Gaidar Institute for Economic Policy in Moscow presented her research study entitled 'Comorbidity and adapting to chronic conditions in Russia’.
Chronic medical conditions are a leading cause of mortality in the world today. Having one condition undoubtedly leads to worsening of health status but comorbidity, or the presence of one or more additional diseases co-occurring with a primary disease, presents an even greater harm to self-assessed health. Further complexity is added in the case of multimorbidity, or the simultaneous presence of two or more chronic conditions in an individual. The management of multimorbidity is often challenging, with patients encountering a number of problems including attending multiple appointments and managing complex drug regimens.
Using RLMS data, Maria Kaneva studied the prevalence of multimorbidities and comorbidities in Russia, comparing it with the prevalence found in other works based on data from the Russian Federation. The author found that multimorbidity has pronounced gender and age differences with women reporting more conditions then men and prevalence of chronic conditions drastically rising with age. Throughout the seminar, Kaneva highlighted that the striking gender difference could be explained by the fact that women tend to see a doctor more often and tend to interact more with the healthcare sector in general. On the other hand, men tend to report only conditions that seriously bother them or prevent them from work.
However, there is evidence that successful monitoring and self-management of chronic conditions by undergoing life style changes necessary to live with an illness which will not go away can lead to the improvement of health status. To explore this key process, Kaneva presented an econometric framework of the mechanism of adapting to chronic conditions. Using examples of the most prevalent comorbidities in the RLMS data for 2014 – that of heart disease, joint disease, and hypertension (for females only) the author explained that an application of a generalized ordered logit framework can demonstrate a pattern of adaptation to comorbidities. This pattern manifests itself in the improvement of self-assessed health for people that have an index condition plus another disease in comparison with respondents that developed an index condition only. In addition, Kaneva found out that adaptation is much less probable in the case of severe and disabling illnesses such as cancer or multiple sclerosis.
Finally, Kaneva highlighted that comorbidity and multimoribidity are real-life issues which a lot of people in Russia have to learn to live with. Especially in the case of multimorbidities, there is a pronounced lack of access to specialist help. Thus, we need to rethink our approach on how to treat multimorbidity even if adequate care is limited to self-management at home. Relating the issue to econometric models could give us some clues on how to ease the struggle that patients experience when trying to manage their conditions well. Under the supervision of Prof. Christopher Gerry, Kaneva will continue working on the robustness of the framework and the extent to which it can be tested in countries where data on the prevalence of chronic illnesses is collected.
We would like to remind you that CHEMP Summer School is taking place on 19 and 20 June, 2017. The topic of this year’s Summer School is 'Part I: Health Outcomes Measurement. Eq-5d: An Introduction From A-Z'.
To find out more, please visit: http://scem.spb.hse.ru/en/chemp/summerschool2017
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