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A systematic review of cost-of-illness studies of multimorbidity


Wang, L and Si, L and Cocker, F and Palmer, AJ and Sanderson, K, A systematic review of cost-of-illness studies of multimorbidity, Applied Health Economics and Health Policy, 16, (1) pp. 15-29. ISSN 1175-5652 (2018) [Refereed Article]

Copyright Statement

Copyright 2017 Springer International Publishing

DOI: doi:10.1007/s40258-017-0346-6


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.

Item Details

Item Type:Refereed Article
Research Division:Economics
Research Group:Applied economics
Research Field:Health economics
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Wang, L (Ms Lilli Wang)
UTAS Author:Si, L (Mr Lei Si)
UTAS Author:Cocker, F (Dr Fiona Cocker)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
UTAS Author:Sanderson, K (Associate Professor Kristy Sanderson)
ID Code:123060
Year Published:2018 (online first 2017)
Web of Science® Times Cited:8
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-12-14
Last Modified:2020-03-13

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