Grace Sum1, Marie Ishida2, Gerald Choon-Huat Koh1, Ankur Singh3, Brian Oldenburg2, John Tayu Lee2,4. 1. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. 2. Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. 3. Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. 4. Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, England, United Kingdom.
Abstract
BACKGROUND: Multimorbidity, the presence of 2 or more non-communicable diseases (NCDs), is a major contributor to inequalities of health in Australia and Japan. We use nationally representative data to examine (i) the relationships between multimorbidity with healthcare utilisation and productivity loss and (ii) whether these relationships differed by socioeconomic groups. METHODS: Cross-sectional analyses using the Household, Income, and Labour Dynamics in Australia (HILDA) and the Japanese Study of Aging and Retirement (JSTAR) surveys. We examined 6,382 (HILDA) and 3,503 (JSTAR) adults aged ≥50 years. We applied multivariable regression, logistic and negative binomial models. RESULTS: Prevalence of multimorbidity was overall 38.6% (46.0%, 36.1%, 28.9% amongst those in the lowest, middle and highest education group, respectively) in Australia, and 28.4% (33.9%, 24.6%, 16.6% amongst those in the lowest, middle and highest education group, respectively) in Japan. In Australia and Japan, more NCDs was associated with greater healthcare utilisation. In Australia and Japan, more NCDs was associated with higher mean number of sick leave days amongst the employed and lower odds of being employed despite being in the labour force. The association between multimorbidity and lower retirement age was found in Australia only. CONCLUSION: Having more NCDs pose significant economic burden to the health system and wider society in Australia and Japan. Targeted policies are critical to improve financial protection, especially for lower income groups who are more likely to have multiple NCDs. These individuals incur both high direct and indirect costs, which lead to a greater risk of impoverishment.
BACKGROUND: Multimorbidity, the presence of 2 or more non-communicable diseases (NCDs), is a major contributor to inequalities of health in Australia and Japan. We use nationally representative data to examine (i) the relationships between multimorbidity with healthcare utilisation and productivity loss and (ii) whether these relationships differed by socioeconomic groups. METHODS: Cross-sectional analyses using the Household, Income, and Labour Dynamics in Australia (HILDA) and the Japanese Study of Aging and Retirement (JSTAR) surveys. We examined 6,382 (HILDA) and 3,503 (JSTAR) adults aged ≥50 years. We applied multivariable regression, logistic and negative binomial models. RESULTS: Prevalence of multimorbidity was overall 38.6% (46.0%, 36.1%, 28.9% amongst those in the lowest, middle and highest education group, respectively) in Australia, and 28.4% (33.9%, 24.6%, 16.6% amongst those in the lowest, middle and highest education group, respectively) in Japan. In Australia and Japan, more NCDs was associated with greater healthcare utilisation. In Australia and Japan, more NCDs was associated with higher mean number of sick leave days amongst the employed and lower odds of being employed despite being in the labour force. The association between multimorbidity and lower retirement age was found in Australia only. CONCLUSION: Having more NCDs pose significant economic burden to the health system and wider society in Australia and Japan. Targeted policies are critical to improve financial protection, especially for lower income groups who are more likely to have multiple NCDs. These individuals incur both high direct and indirect costs, which lead to a greater risk of impoverishment.
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