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

journal contribution
posted on 2023-05-19, 14:10 authored by Wang, L, Lei SiLei Si, Fiona CockerFiona Cocker, Andrew PalmerAndrew Palmer, Kristy Sanderson
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.

History

Publication title

Applied Health Economics and Health Policy

Volume

16

Pagination

15-29

ISSN

1175-5652

Department/School

Menzies Institute for Medical Research

Publisher

Adis International Ltd.

Place of publication

New Zealand

Rights statement

Copyright 2017 Springer International Publishing

Repository Status

  • Restricted

Socio-economic Objectives

Evaluation of health and support services not elsewhere classified

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