Multiple chronic conditions and healthcare costs among adults

Abstract

The prevalence of multiple chronic conditions (MCC) is increasing among individuals of all ages. MCC are associated with poor health outcomes. The presence of MCC has profound healthcare utilization and cost implications for public and private insurance payers, individuals, and families. Investigators have used a variety of definitions for MCC to evaluate costs associated with MCC. The objective of this article is to examine the current literature in estimating excess costs associated with MCC among adults. The discussion highlights some of the theoretical and technical merits of various MCC definitions and models used to estimate the excess costs associated with MCC.

Keywords:

• comorbidity
• cost burden
• expenditures
• multimorbidity
• multiple chronic conditions
• out-of-pocket costs

Acknowledgements

The authors would like to thank Dr. Constance Weiner for suggesting some reference articles.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or policy or position of West Virginia University (WVU) or any other affiliated organizations.

Financial & competing interests disclosure

The project described was partially supported by the National Institute of General Medical Sciences, U54GM104942. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Multimorbidity is highly prevalent throughout the world.

• The presence of multiple chronic conditions (MCC) in the same individual has profound implications for healthcare costs and utilization.

• There is neither a universal operational definition of MCC available in the literature nor a standard way to estimate MCC, which in turn complicates cost evaluation of MCC.

• Most current studies used additive models to assess costs, but given that costs could vary by different types of combination of chronic conditions, cost estimation of MCC should also take into account these interactions and their effects on costs.

• There is limited literature on indirect costs associated with MCC. A good estimation of monetary evaluations of productivity losses is needed.