Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study)
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 morbid...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Health Research Policy and Systems |
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| Online Access: | https://doi.org/10.1186/s12961-024-01113-x |
| _version_ | 1797246954281893888 |
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| author | Phuong Bich Tran Georgios F. Nikolaidis Emmanuel Abatih Philippe Bos Finaba Berete Vanessa Gorasso Johan Van der Heyden Joseph Kazibwe Ewan Morgan Tomeny Guido Van Hal Philippe Beutels Josefien van Olmen |
| author_facet | Phuong Bich Tran Georgios F. Nikolaidis Emmanuel Abatih Philippe Bos Finaba Berete Vanessa Gorasso Johan Van der Heyden Joseph Kazibwe Ewan Morgan Tomeny Guido Van Hal Philippe Beutels Josefien van Olmen |
| author_sort | Phuong Bich Tran |
| collection | DOAJ |
| description | 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 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. |
| first_indexed | 2024-04-24T19:51:00Z |
| format | Article |
| id | doaj.art-ba98b5be85984af389bad06171143a32 |
| institution | Directory Open Access Journal |
| issn | 1478-4505 |
| language | English |
| last_indexed | 2024-04-24T19:51:00Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Research Policy and Systems |
| spelling | doaj.art-ba98b5be85984af389bad06171143a322024-03-24T12:37:33ZengBMCHealth Research Policy and Systems1478-45052024-03-0122112110.1186/s12961-024-01113-xMultimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study)Phuong Bich Tran0Georgios F. Nikolaidis1Emmanuel Abatih2Philippe Bos3Finaba Berete4Vanessa Gorasso5Johan Van der Heyden6Joseph Kazibwe7Ewan Morgan Tomeny8Guido Van Hal9Philippe Beutels10Josefien van Olmen11Department of Family Medicine and Population Health, University of AntwerpIQVIA LtdDepartment of Applied Mathematics, Computer Sciences and Statistics, Ghent UniversityDepartment of Sociology, University of AntwerpDepartment of Epidemiology and public healthDepartment of Epidemiology and public healthDepartment of Epidemiology and public healthDepartment of Clinical Sciences, Lund UniversityDepartment of Clinical Sciences, Liverpool School of Tropical MedicineDepartment of Family Medicine and Population Health, University of AntwerpCentre for Health Economics Research & Modelling Infectious Diseases (CHERMID), University of AntwerpDepartment of Family Medicine and Population Health, University of AntwerpAbstract 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.https://doi.org/10.1186/s12961-024-01113-xCost analysisHealthcare expenditureMultimorbidityChronic diseasesNoncommunicable diseasesDisease interaction |
| spellingShingle | Phuong Bich Tran Georgios F. Nikolaidis Emmanuel Abatih Philippe Bos Finaba Berete Vanessa Gorasso Johan Van der Heyden Joseph Kazibwe Ewan Morgan Tomeny Guido Van Hal Philippe Beutels Josefien van Olmen Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study) Health Research Policy and Systems Cost analysis Healthcare expenditure Multimorbidity Chronic diseases Noncommunicable diseases Disease interaction |
| title | Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study) |
| title_full | Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study) |
| title_fullStr | Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study) |
| title_full_unstemmed | Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study) |
| title_short | Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study) |
| title_sort | multimorbidity healthcare expenditure in belgium a 4 year analysis comorb study |
| topic | Cost analysis Healthcare expenditure Multimorbidity Chronic diseases Noncommunicable diseases Disease interaction |
| url | https://doi.org/10.1186/s12961-024-01113-x |
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