Optimal prevention strategies for chronic diseases in a compartmental disease trajectory model

In countries with growing elderly populations, multimorbidity poses a significant healthcare challenge. The trajectories along which diseases accumulate as patients age and how they can be targeted by prevention efforts are still not fully understood. We propose a compartmental model, traditionally used in infectious diseases, describing chronic disease trajectories across 132 distinct multimorbidity patterns (compartments). Leveraging a comprehensive dataset from approximately 45 million hospital stays spanning 17 years in Austria, our compartmental disease trajectory model (CDTM) forecasts changes in the incidence of 131 diagnostic groups and their combinations until 2030, highlighting patterns involving hypertensive diseases with cardiovascular diseases and metabolic disorders. We pinpoint specific diagnoses with the greatest potential for preventive interventions to promote healthy aging. According to our model, a reduction of new onsets by 5% of hypertensive diseases (I10-I15) leads to a reduction in all-cause mortality over a period of 15 years by 0.57 (0.06)% and for malignant neoplasms (C00-C97) mortality is reduced by 0.57 (0.07)%. Furthermore, we use the model to assess the long-term consequences of the Covid-19 pandemic on hospitalizations, revealing earlier and more frequent hospitalizations across multiple diagnoses. Our fully data-driven approach identifies leverage points for proactive preparation by physicians and policymakers to reduce the overall disease burden in the population, emphasizing a shift towards patient-centered care.