Impact of multimorbidity on healthcare costs and utilisation: a systematic review of the UK literature

Managing multimorbidity is complex for both patients and healthcare systems. Patients with multimorbidity often use a variety of primary and secondary care services. Country-specific research exploring the healthcare utilisation and cost consequences of multimorbidity may inform future interventions...

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Bibliographic Details
Published in:British journal of general practice Vol. 71; no. 702; p. e39
Main Authors: Soley-Bori, Marina, Ashworth, Mark, Bisquera, Alessandra, Dodhia, Hiten, Lynch, Rebecca, Wang, Yanzhong, Fox-Rushby, Julia
Format: Journal Article
Language:English
Published: England 01.01.2021
Subjects:
Delivery of Health Care
Health Care Costs
Humans
Multimorbidity
Primary Health Care
United Kingdom - epidemiology
United Kingdom
multimorbidity
primary care
depression
systematic review
healthcare costs
healthcare use
ISSN:1478-5242, 1478-5242
Online Access:Get more information
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Summary:Managing multimorbidity is complex for both patients and healthcare systems. Patients with multimorbidity often use a variety of primary and secondary care services. Country-specific research exploring the healthcare utilisation and cost consequences of multimorbidity may inform future interventions and payment schemes in the UK. To assess the relationship between multimorbidity, healthcare costs, and healthcare utilisation; and to determine how this relationship varies by disease combinations and healthcare components. A systematic review. This systematic review followed the bidirectional citation searching to completion method. MEDLINE and grey literature were searched for UK studies since 2004. An iterative review of references and citations was completed. Authors from all articles selected were contacted and asked to check for completeness of UK evidence. The National Institutes of Health National Heart, Lung, and Blood Institute quality assessment tool was used to assess risk of bias. Data were extracted, findings synthesised, and study heterogeneity assessed; meta-analysis was conducted when possible. Seventeen studies were identified: seven predicting healthcare costs and 10 healthcare utilisation. Multimorbidity was found to be associated with increased total costs, hospital costs, care transition costs, primary care use, dental care use, emergency department use, and hospitalisations. Several studies demonstrated the high cost of depression and of hospitalisation associated with multimorbidity. In the UK, multimorbidity increases healthcare utilisation and costs of primary, secondary, and dental care. Future research is needed to examine whether integrated care schemes offer efficiencies in healthcare provision for multimorbidity.
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ISSN:1478-5242
1478-5242
DOI:10.3399/bjgp20X713897