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Multimorbidity heal...
Multimorbidity healthcare expenditure in Belgium : a 4-year analysis (COMORB study)
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- Tran, Phuong Bich (author)
- Sciensano,University of Antwerp
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- Nikolaidis, Georgios F. (author)
- IQVIA, United Kingdom
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- Abatih, Emmanuel (author)
- Ghent University
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- Bos, Philippe (author)
- University of Antwerp
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- Berete, Finaba (author)
- Sciensano
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- Gorasso, Vanessa (author)
- Sciensano
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- Van der Heyden, Johan (author)
- Sciensano
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- Kazibwe, Joseph (author)
- Lund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups
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- Tomeny, Ewan Morgan (author)
- Liverpool School of Tropical Medicine
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- Van Hal, Guido (author)
- University of Antwerp
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- Beutels, Philippe (author)
- University of Antwerp
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- van Olmen, Josefien (author)
- University of Antwerp
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: Health Research Policy and Systems. - 1478-4505. ; 22:1
- Related links:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Keyword
- Belgium
- Chronic diseases
- Cost analysis
- Disease interaction
- Healthcare expenditure
- Integrated care
- Multimorbidity
- Noncommunicable diseases
Publication and Content Type
- art (subject category)
- ref (subject category)
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Tran, Phuong Bic ...
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Nikolaidis, Geor ...
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Abatih, Emmanuel
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Bos, Philippe
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Berete, Finaba
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Gorasso, Vanessa
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Van der Heyden, ...
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Kazibwe, Joseph
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Tomeny, Ewan Mor ...
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Van Hal, Guido
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Beutels, Philipp ...
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van Olmen, Josef ...
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- MEDICAL AND HEALTH SCIENCES
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Lund University