Multimorbidity is associated with higher out-of-pocket spending: a study of older Australians with multiple chronic conditions

McRae, Ian; Yen, Laurann; Jeon, Yun‐Hee; Herath, Pushpani; Essue, Beverley M

doi:10.1071/py12035

Cited by 78 publications

(119 citation statements)

References 16 publications

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“…[5][6][7][8][9] Each additional chronic disease adds 46% to the likelihood that a person faces severe financial difficulties, often compounding existing levels of financial stress. 10,11 What is the impact of increasing co-payments on healthcare access and outcomes?…”

Section: What Out-of-pocket Expenditures Do Australian Health Consumementioning

confidence: 99%

Co-payments for health care: what is their real cost?

Laba

Usherwood

Leeder

et al. 2015

Aust. Health Review

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Abstract. Based on the premise that current trends in healthcare spending are unsustainable, the Australian Government has proposed in the recent Budget the introduction of a compulsory $7 co-payment to visit a General Practitioner (GP), alongside increased medication copayments. This paper is based on a recent submission to the Senate Inquiry into the impact of out-of-pocket costs in Australia. It is based on a growing body of evidence highlighting the substantial economic burden faced by individuals and families as a result of out-of-pocket costs for health care and their flow-on effects on healthcare access, outcomes and long-term healthcare costs. It is argued that a compulsory minimum co-payment for GP consultations will exacerbate these burdens and significantly undermine the tenets of universal access in Medicare. Alternative recommendations are provided that may help harness unsustainable health spending while promoting an equitable and fair health system.

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Section: What Out-of-pocket Expenditures Do Australian Health Consumementioning

confidence: 99%

Co-payments for health care: what is their real cost?

Laba

Usherwood

Leeder

et al. 2015

Aust. Health Review

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“…In total, fourteen studies provided the same, clear defin ition of mu lt imorbid ity, i.e., the ≥2 simple count 17 method [23,13,29,35,30,31,41,37,38,45,39,40,32,43]. Twelve studies estimated the costs by number,…”

mentioning

confidence: 99%

“…States [23,24,3,[25][26][27][28][29][30][31][32][33][34], seven in Europe [13,[35][36][37][38][39][40], t wo in Australia [41], one each fro m Canada [42], Singapore 3 [43] and Taiwan [44], and two in middle -or low-inco me regions [40,45]. Overall, twenty studies used a prevalence 4 approach [23, 24, 3, 25-28, 13, 35, 30, 31, 41, 37, 38, 45, 39, 46, 40, 32, 43], seven used an incidence approach [36, 5 29, 44, 42, 33, 34, 27], and only one used an economic model to estimate the lifet ime costs of mult imorb idity [36].…”

mentioning

confidence: 99%

A Systematic Review of Cost-of-Illness Studies of Multimorbidity

Wang

Liu

Cocker

et al. 2017

Appl Health Econ Health Policy

137

120

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1Objectives: The economic burden of mu ltimo rbid ity is considerable. This review analyzed the methods of cost-of-2 illness (COI) studies and summarized the economic outcomes of mu ltimo rbidity. 3Methods: A systematic review (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) was performed, which was registered with Prospero, reported according 4 to PRISMA, and used a quality checklist adapted for COI studies . The inclusion criteria were peer-reviewed COI 5 studies on multimo rbidity, whereas the exclusion criterion was studies focusing on an index d isease. Ext racted data 6 included the definition, measure, and prevalence of mult imorb idity; the number of included hea lth conditions; the 7 age of study population; the variables used in the COI methodology; the percentage of mu ltimorb idity vs. total costs; 8 and the average costs per capita. 9Results: Among the 26 included articles, 14 defined mult imorbid ity as a simple coun t of 2 or mo re conditions. 10Methodologies used to derive the costs were markedly d ifferent. Given different healthcare systems, OOP pay ments 11 of mult imorbid ity varied across countries. In the 17 and 12 studies with cut-offs of ≥2 and ≥3 condit ions, 12respectively, the ratios of multimo rbid ity to non-mult imorbid ity costs ranged from 2-16 and 2-10. A mong the 10 13 studies that provided cost breakdowns, studies with and without a societal perspective attributed the largest 14 percentage of mult imorb idity costs to social care and inpatient care/med icine, respectively. 15Conclusion: Multimorbid ity was associated with considerable economic burden . Synthesising the cost of 16 mu ltimo rbidity was challenging due to mu ltip le definitions of mult imorb idity and heterogeneity in COI methods. 17Count method was most popular to define mu ltimo rbid ity. There is consistent evidence that multimo rbidity was 18 associated with higher costs.

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“…De igual forma complementa estudios con respecto a la carga del cuidado para el sistema [43][44][45], para la familia [46] y para el cuidador familiar [47], involucrando al sujeto directamente implicado en la experiencia de vivir con una enfermedad crónica.…”

Section: Discussionunclassified

Diseño, validez facial y de contenido del instrumento carga de la enfermedad crónica para el paciente – GPCP-UN

Herrera

González

Cárdenas

et al. 2017

Rev. Médica Risaralda

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Objetivo: Diseñar y realizar validación facial y de contenido del instrumento Carga de la Enfermedad Crónica para el PacienteMétodo: Estudio descriptivo desarrollado entre los años 2012 – 2015, en las siguientes fases: 1) Revisión de la literatura. 2) Recuento y evaluación y de síntomas, quejas y preocupaciones expresadas por 1850 pacientes con seguimiento de un año. 3) Construcción del instrumento 4) Prueba de comprensibilidad y ajuste semántico 5) Pruebas de validez facial y de contenido con expertos. Resultados. El instrumento “Carga de la Enfermedad Crónica para el Paciente – GCPC-UN” consta de 49 ítems distribuidos en tres dimensiones: el sufrimiento psicológico y espiritual, con 15 ítems; el disconfort y malestar físico, con 19 ítems; y la alteración socio cultural y familiar con 15 ítems. Se incluye 1 pregunta final que da opciones de problemas, quejas o síntomas no incluidos. Cada situación que se asocia con la enfermedad es medida en términos de la frecuencia, la intensidad y el nivel en que es considerada amenazante o peligrosa. Conclusiones. El Instrumento “Carga de la Enfermedad Crónica para el Paciente – GCPC-UN” permite valorar integralmente el impacto que la situación de enfermedad crónica genera a la persona con la enfermedad. Los resultados de sus pruebas de comprensibilidad, validez facial y contenido, avalan su aplicación en el contexto Colombiano y son base para nuevas investigaciones en el campo.

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Multimorbidity is associated with higher out-of-pocket spending: a study of older Australians with multiple chronic conditions

Cited by 78 publications

References 16 publications

Co-payments for health care: what is their real cost?

Co-payments for health care: what is their real cost?

A Systematic Review of Cost-of-Illness Studies of Multimorbidity

Diseño, validez facial y de contenido del instrumento carga de la enfermedad crónica para el paciente – GPCP-UN

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