Die Morbiditätskompressionsthese und ihre Alternativen

Zusammenfassung

Ziel: Nach Fries’ Morbiditätskompressionsthese nehmen die Zeiten, die Menschen im Zustand von chronischer Krankheit und Behinderung verbringen, ab. Dies wird erklärt durch verbesserte Lebens- und Arbeitsbedingungen sowie durch Erfolge der primären Prävention.

Methodik: Anhand der vorliegenden Studien zur Morbiditätskompression wird untersucht, ob sich das Morbiditätsgeschehen in den letzten Jahrzehnten im Sinn der These verändert hat.

Ergebnisse: Für Multimorbidität, manifeste chronische Erkrankungen, kognitive Beeinträchtigungen sowie für subjektive Gesundheit verkürzen sich die Leidenszeiten in Übereinstimmung mit der Kompressionsthese, Variationen ergeben sich in Abhängigkeit von der betrachteten Erkrankung.

Schlussfolgerung: Es gibt Belege dafür, dass in den letzten Jahren neben Morbiditätskompression auch Morbiditätsexpansion und dynamisches Equilibrium eingetreten sind. Eine Gesamtbeurteilung der Entwicklung ist jedoch erst dann möglich, wenn weitere Erkrankungen untersucht werden. Es gibt zudem Hinweise, dass sich die Morbiditätsmuster außerhalb Europas und der USA in andere Richtungen entwickeln.

Abstract

Aim: Fries’ hypothesis of morbidity compression asserts that the length of lifetime spent in states of chronic disease and disability is decreasing. This can be explained by improved living and working conditions and by successful primary prevention.

Method: Using the available studies on morbidity compression it is examined whether the lengths of periods spent in states of morbidity have changed in the last decades.

Results: For multimorbidity, chronic diseases, cognitive impairment, and for subjective health the developments are in favour of the morbidity compression hypothesis. The conclusions are nevertheless dependent on the type of health impairment considered.

Conclusion: There is evidence that morbidity compression has taken place in the last decades. Depending on the disease, morbidity expansion and dynamic equilibrium may also have occurred. A comprehensive assessment of the development of morbidities is only possible if more diseases are considered. In addition, there is evidence that outside of Europe and the USA morbidity patterns may also develop in other directions.

Schlüsselwörter

Morbiditätskompression - Morbiditätsexpansion - Dynamisches Equilibrium - Altern - Morbidität - Gesundheit

Key words

morbidity compression - morbidity expansion - dynamic equilibrium - aging - morbidity - health

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