Multimorbidity healthcare expenditure in Belgium : a 4-year analysis (COMORB study)
(2024) In Health Research Policy and Systems 22(1).- Abstract
Background: The complex management of health needs in multimorbid patients, alongside limited cost data, presents challenges in developing cost-effective patient-care pathways. We estimated the costs of managing 171 dyads and 969 triads in Belgium, taking into account the influence of morbidity interactions on costs. Methods: We followed a retrospective longitudinal study design, using the linked Belgian Health Interview Survey 2018 and the administrative claim database 2017–2020 hosted by the Intermutualistic Agency. We included people aged 15 and older, who had complete profiles (N = 9753). Applying a system costing perspective, the average annual direct cost per person per dyad/triad was presented in 2022 Euro and comprised mainly... (More)
Background: The complex management of health needs in multimorbid patients, alongside limited cost data, presents challenges in developing cost-effective patient-care pathways. We estimated the costs of managing 171 dyads and 969 triads in Belgium, taking into account the influence of morbidity interactions on costs. Methods: We followed a retrospective longitudinal study design, using the linked Belgian Health Interview Survey 2018 and the administrative claim database 2017–2020 hosted by the Intermutualistic Agency. We included people aged 15 and older, who had complete profiles (N = 9753). Applying a system costing perspective, the average annual direct cost per person per dyad/triad was presented in 2022 Euro and comprised mainly direct medical costs. We developed mixed models to analyse the impact of single chronic conditions, dyads and triads on healthcare costs, considering two-/three-way interactions within dyads/triads, key cost determinants and clustering at the household level. Results: People with multimorbidity constituted nearly half of the study population and their total healthcare cost constituted around three quarters of the healthcare cost of the study population. The most common dyad, arthropathies + dorsopathies, with a 14% prevalence rate, accounted for 11% of the total national health expenditure. The most frequent triad, arthropathies + dorsopathies + hypertension, with a 5% prevalence rate, contributed 5%. The average annual direct costs per person with dyad and triad were €3515 (95% CI 3093–3937) and €4592 (95% CI 3920–5264), respectively. Dyads and triads associated with cancer, diabetes, chronic fatigue, and genitourinary problems incurred the highest costs. In most cases, the cost associated with multimorbidity was lower or not substantially different from the combined cost of the same conditions observed in separate patients. Conclusion: Prevalent morbidity combinations, rather than high-cost ones, made a greater contribution to total national health expenditure. Our study contributes to the sparse evidence on this topic globally and in Europe, with the aim of improving cost-effective care for patients with diverse needs.
(Less)
- author
- organization
- publishing date
- 2024-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Belgium, Chronic diseases, Cost analysis, Disease interaction, Healthcare expenditure, Integrated care, Multimorbidity, Noncommunicable diseases
- in
- Health Research Policy and Systems
- volume
- 22
- issue
- 1
- article number
- 35
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:38519938
- scopus:85188422245
- ISSN
- 1478-4505
- DOI
- 10.1186/s12961-024-01113-x
- language
- English
- LU publication?
- yes
- id
- ff8e76d2-52b6-48dd-be1a-b895e024e0c1
- date added to LUP
- 2024-04-15 09:47:50
- date last changed
- 2024-04-16 03:00:11
@article{ff8e76d2-52b6-48dd-be1a-b895e024e0c1,
abstract = {{<p>Background: The complex management of health needs in multimorbid patients, alongside limited cost data, presents challenges in developing cost-effective patient-care pathways. We estimated the costs of managing 171 dyads and 969 triads in Belgium, taking into account the influence of morbidity interactions on costs. Methods: We followed a retrospective longitudinal study design, using the linked Belgian Health Interview Survey 2018 and the administrative claim database 2017–2020 hosted by the Intermutualistic Agency. We included people aged 15 and older, who had complete profiles (N = 9753). Applying a system costing perspective, the average annual direct cost per person per dyad/triad was presented in 2022 Euro and comprised mainly direct medical costs. We developed mixed models to analyse the impact of single chronic conditions, dyads and triads on healthcare costs, considering two-/three-way interactions within dyads/triads, key cost determinants and clustering at the household level. Results: People with multimorbidity constituted nearly half of the study population and their total healthcare cost constituted around three quarters of the healthcare cost of the study population. The most common dyad, arthropathies + dorsopathies, with a 14% prevalence rate, accounted for 11% of the total national health expenditure. The most frequent triad, arthropathies + dorsopathies + hypertension, with a 5% prevalence rate, contributed 5%. The average annual direct costs per person with dyad and triad were €3515 (95% CI 3093–3937) and €4592 (95% CI 3920–5264), respectively. Dyads and triads associated with cancer, diabetes, chronic fatigue, and genitourinary problems incurred the highest costs. In most cases, the cost associated with multimorbidity was lower or not substantially different from the combined cost of the same conditions observed in separate patients. Conclusion: Prevalent morbidity combinations, rather than high-cost ones, made a greater contribution to total national health expenditure. Our study contributes to the sparse evidence on this topic globally and in Europe, with the aim of improving cost-effective care for patients with diverse needs.</p>}},
author = {{Tran, Phuong Bich and Nikolaidis, Georgios F. and Abatih, Emmanuel and Bos, Philippe and Berete, Finaba and Gorasso, Vanessa and Van der Heyden, Johan and Kazibwe, Joseph and Tomeny, Ewan Morgan and Van Hal, Guido and Beutels, Philippe and van Olmen, Josefien}},
issn = {{1478-4505}},
keywords = {{Belgium; Chronic diseases; Cost analysis; Disease interaction; Healthcare expenditure; Integrated care; Multimorbidity; Noncommunicable diseases}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Health Research Policy and Systems}},
title = {{Multimorbidity healthcare expenditure in Belgium : a 4-year analysis (COMORB study)}},
url = {{http://dx.doi.org/10.1186/s12961-024-01113-x}},
doi = {{10.1186/s12961-024-01113-x}},
volume = {{22}},
year = {{2024}},
}