No evidence of morbidity compression in Spain: a time series study based on national hospitalization records

Stefan Walter, Hiram Beltrán-Sánchez, Enrique Regidor, Carlos Gomez-Martin, Jose Luis del-Barrio, Angel Gil-de-Miguel, S. V. Subramanian, Ruth Gil-Prieto

Compression of morbidity postulates that as the populations age, the age of onset of disease is postponed. The objective of this study is to test for evidence of compression of morbidity in Spain. We calculated the age and sex-specific incidence of myocardial infarction, heart failure, cerebrovascular disease, as well as bladder, prostate, breast, lung, and colon cancer among hospital discharges covering 99.5 % of the Spanish population, approximately 40 million inhabitants for two non-overlapping periods, 1997-2000 and 2007-2010, and estimated the length of life spent with disease using the Sullivan method. We found that expansion of morbidity due to an earlier age-specific onset of incident disease and increase in life expectancy was the norm in Spain. Notable exceptions were cardiovascular disease in women (-0.2 % time spent with disease) and lung cancer for men (-0.9 % time spent with disease) from 1997-2000 to 2007-2010. Compression of morbidity is often cited by policy makers when discussing adjustments to the health-care system. If morbidity is measured by age at onset of disease, the burden of morbidity has increased in Spain.