Lili Wang1, Lei Si1, Fiona Cocker1,2, Andrew J Palmer1, Kristy Sanderson3,4. 1. Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia. 2. School of Medicine and University of Tasmania, Hobart, Tasmania, Australia. 3. School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK. Kristy.Sanderson@uea.ac.uk. 4. Menzies Institute for Medical Research and University of Tasmania, Hobart, Tasmania, Australia. Kristy.Sanderson@uea.ac.uk.
Abstract
OBJECTIVES: The economic burden of multimorbidity is considerable. This review analyzed the methods of cost-of-illness (COI) studies and summarized the economic outcomes of multimorbidity. METHODS: A systematic review (2000-2016) was performed, which was registered with Prospero, reported according to PRISMA, and used a quality checklist adapted for COI studies. The inclusion criteria were peer-reviewed COI studies on multimorbidity, whereas the exclusion criterion was studies focusing on an index disease. Extracted data included the definition, measure, and prevalence of multimorbidity; the number of included health conditions; the age of study population; the variables used in the COI methodology; the percentage of multimorbidity vs. total costs; and the average costs per capita. RESULTS: Among the 26 included articles, 14 defined multimorbidity as a simple count of 2 or more conditions. Methodologies used to derive the costs were markedly different. Given different healthcare systems, OOP payments of multimorbidity varied across countries. In the 17 and 12 studies with cut-offs of ≥2 and ≥3 conditions, respectively, the ratios of multimorbidity to non-multimorbidity costs ranged from 2-16 to 2-10. Among the ten studies that provided cost breakdowns, studies with and without a societal perspective attributed the largest percentage of multimorbidity costs to social care and inpatient care/medicine, respectively. CONCLUSION: Multimorbidity was associated with considerable economic burden. Synthesising the cost of multimorbidity was challenging due to multiple definitions of multimorbidity and heterogeneity in COI methods. Count method was most popular to define multimorbidity. There is consistent evidence that multimorbidity was associated with higher costs.
OBJECTIVES: The economic burden of multimorbidity is considerable. This review analyzed the methods of cost-of-illness (COI) studies and summarized the economic outcomes of multimorbidity. METHODS: A systematic review (2000-2016) was performed, which was registered with Prospero, reported according to PRISMA, and used a quality checklist adapted for COI studies. The inclusion criteria were peer-reviewed COI studies on multimorbidity, whereas the exclusion criterion was studies focusing on an index disease. Extracted data included the definition, measure, and prevalence of multimorbidity; the number of included health conditions; the age of study population; the variables used in the COI methodology; the percentage of multimorbidity vs. total costs; and the average costs per capita. RESULTS: Among the 26 included articles, 14 defined multimorbidity as a simple count of 2 or more conditions. Methodologies used to derive the costs were markedly different. Given different healthcare systems, OOP payments of multimorbidity varied across countries. In the 17 and 12 studies with cut-offs of ≥2 and ≥3 conditions, respectively, the ratios of multimorbidity to non-multimorbidity costs ranged from 2-16 to 2-10. Among the ten studies that provided cost breakdowns, studies with and without a societal perspective attributed the largest percentage of multimorbidity costs to social care and inpatient care/medicine, respectively. CONCLUSION: Multimorbidity was associated with considerable economic burden. Synthesising the cost of multimorbidity was challenging due to multiple definitions of multimorbidity and heterogeneity in COI methods. Count method was most popular to define multimorbidity. There is consistent evidence that multimorbidity was associated with higher costs.
Authors: Phuong Bich Tran; Joseph Kazibwe; Georgios F Nikolaidis; Ismo Linnosmaa; Mieke Rijken; Josefien van Olmen Journal: BMC Med Date: 2022-07-19 Impact factor: 11.150
Authors: Andrew M Briggs; Jeremy Shiffman; Yusra Ribhi Shawar; Kristina Åkesson; Nuzhat Ali; Anthony D Woolf Journal: Best Pract Res Clin Rheumatol Date: 2020-07-23 Impact factor: 4.098
Authors: Ana Patricia Marques; Jacqueline Ramke; John Cairns; Thomas Butt; Justine H Zhang; Hannah B Faal; Hugh Taylor; Iain Jones; Nathan Congdon; Andrew Bastawrous; Tasanee Braithwaite; Marty Jovic; Serge Resnikoff; Allyala Nandakumar; Peng Tee Khaw; Rupert R A Bourne; Iris Gordon; Kevin Frick; Matthew J Burton Journal: BMJ Open Date: 2020-09-06 Impact factor: 2.692