The role of mental disease on the association between multimorbidity and medical expenditure

Abstract

Background Multimorbidity is the presence of two or more chronic diseases and is associated with increased adverse outcomes, including hospitalization, mortality and frequency of use of medical institutions. Objective This study aimed to describe multimorbidity patterns, determine whether multimorbidity was associated with high medical expenditure, and determine whether mental diseases had an interaction effect on this association. Methods We conducted a claims data-based observational study. Data were obtained for 7526 individuals aged 0–75 years from a medical claims data set for Goto, Japan, over a 12-month period (2016–17). Annual medical expenditure was divided into quintiles; the fifth quintile represented high medical expenditure. Multimorbidity status was defined as the occurrence of two or more health conditions from 17 specified conditions. Odds ratios (OR) and 95% confidence intervals (CI) for high medical expenditure were calculated by number of comorbidities. Results In total, 5423 (72.1%) participants had multimorbidity. Multimorbidity was significantly associated with high medical expenditure, even after adjustment for age, sex and income category (OR: 10.36, 95% CI: 7.57–14.19; P < 0.001). Mental diseases had a significant interaction effect on the association between multimorbidity and high medical expenditure (P = 0.001). Conclusions Multimorbidity is associated with high medical expenditure in Japan. Mental diseases may contribute to increased medical costs.

Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China

“…In addition, pro-rich inequity of healthcare utilization is also more likely to occur in chronic diseases with high medical expenditure. In Japan, kidney diseases, stroke and neurological diseases are most likely to lead to high medical expenditure, whereas chronic respiratory diseases are less associated with high medical expenditure than other diseases [ 53 ]. In Mexico, the top four most expensive chronic diseases are chronic kidney disease, arterial hypertension, type 2 diabetes and chronic ischemic heart disease accounting for more than 85% of the total financial burden of chronic diseases [ 54 ].…”

Multicentric validation of a Multimorbidity Adjusted Disability Score to stratify depression-related risks using temporal disease maps

“…The results reported in this study not only reaffirm the well-established link between multimorbidity and adverse outcomes such as a decline in functional status, compromised quality of life, and increased mortality rates 33 but also shed light on the significant burden imposed on individuals and healthcare systems. The strain on resource allocation and overall healthcare spending is a pressing concern that necessitates effective strategies for addressing and managing multimorbidity 34 .…”

“…The copyright holder for this preprint this version posted September 4, 2023. ; https://doi.org/10.1101/2023.09.04.23295005 doi: medRxiv preprint allocation and overall healthcare spending is a pressing concern that necessitates effective strategies for addressing and managing multimorbidity 34 .…”

Identification of risk factors for elevated serum IgG4 levels in subjects in a large-scale health checkup cohort study

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