Nearly one-quarter of all health system expenditure for chronic disease care was attributed to costs associated with comorbid conditions, above and beyond the projected cost of having the diseases separately, according to research published in PLOS Medicine.
“There is a surprising lack of disease-attributed studies involving multiple diseases at once, Tony Blakely, PhD, MBChB, MPH, FAFPHM, of the University of Otago, New Zealand, and colleagues said in a press release. “Governments and health systems managers and funders can improve planning and prioritization knowing where the money goes.”
To determine the amount of publicly-funded expenditures by disease phase for noncommunicable diseases in New Zealand, and to analyze the cost of having multiple noncommunicable diseases compared with the independent cost of each condition, Blakely and colleagues used nationally linked health data for all New Zealanders. This included hospitalization, outpatient, pharmaceutical, laboratory and primary care from July 1, 2007, through June 30, 2014. These data represented 18.9 million person-years and U.S. $26.4 billion in spending, based on 2016 dollars.
The researchers calculated annual health expenditures per person and evaluated the association between this spending and whether a patient demonstrated one or more of six noncommunicable disease classes. These conditions included cancer, cardiovascular disease, diabetes, musculoskeletal disease, neurological diseases and lung, liver or kidney diseases.
According to the researchers, 59% of publicly funded health expenditures in the country were attributable to noncommunicable diseases, with 23.8% of such spending dedicated to treating patients with multiple noncommunicable diseases, in addition to what the diseases would cost separately. Of the remaining expenditures, 18.7% went to care for heart disease and stroke, 16.2% for musculoskeletal care, 14.4% for neurological disease, 14.4% for cancer, 7.4% for lung, liver or kidney diseases, and 5.5% for diabetes. Spending was in general highest for each patient during the year of diagnosis and the year of death.
“Put another way, if there were no additional costs due to the complexity of having two or more diseases at the same time, we would spend a quarter less on chronic conditions,” Blakely said in the release. “Multimorbidity is likely to be an increasing driver of health spending in future, as people live longer. What stands out is the high cost of musculoskeletal and neurological diseases — to an extent greater than the priority we give them in planning and health services research.” – by Jason Laday
Date: January 11, 2019