MULTIMORBIDITY AND HEALTH SYSTEM COSTS AMONG OLDER ADULTS IN ONTARIO, CANADA

Saturday, January 9, 2016
Foyer, G/F (Jockey Club School of Public Health and Primary Care Building at Prince of Wales Hospital)

Kednapa Thavorn, PhD1, Yu Qing Bai, MSc2, Colleen Maxwell, PhD3, Andrea Grunier, PhD4, Susan Bronskill, PhD2, Anna Kone Pefoyo, PhD5, Yelena Petrosyan, MD, MPH6 and Walter Wodchis, PhD7, (1)The Ottawa Hospital Research Institute, Ottawa, ON, Canada, (2)Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, (3)Schools of Pharmacy and Public Health and Health Systems, University of Waterloo, Kitchener, ON, Canada, (4)Department of Family Medicine, University of Alberta, Edmonton, AB, Canada, (5)Cancer Care Ontario, Toronto, ON, Canada, (6)Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada, (7)University of Toronto, Toronto, ON, Canada
Purpose:

Multimorbidity, the presence of the two or more medical conditions within a single person, is increasingly prevalent due to advances in life-extending treatments and increases in life expectancy. The cost implications of multimorbidity, particularly from healthcare payers and health insurers, are important to quantify and examine. This study estimated health system costs attributable to multimorbidity in older adults using an economic modelling approach and assessed whether the association between multimorbidity and costs vary according to health service sectors, including physician, hospital, continuing care, medication, and other sector.  

Method(s):

This population-based, cross-sectional study was conducted in the province of Ontario, Canada. We included all 1,634,390 Ontarians aged 65 years or older who were diagnosed with at least one of 16 selected chronic conditions on April 1, 2009. Annual healthcare costs were derived from linked provincial health administrative databases using a person-level costing method. Costs were estimated from the perspective of the publicly funded healthcare system using a generalized linear model with a log-link function and a gamma distribution.   

Result(s):

In 2009, nearly 80% of total healthcare costs in Ontario was spent on individuals with two or more chronic conditions. Healthcare costs rose exponentially with an increase in the number of chronic conditions even after controlling for confounding factors. A greater level of deprivation, instability, or dependency was significantly associated with higher health system costs. However, living in a higher neighborhood income and a greater degree of urbanization significantly lowered health system costs.  Comparative effects of multimorbidity on costs across health service sectors will be presented. 

Conclusion(s):

Healthcare costs associated with multimorbidity were substantial. To control the growth in healthcare spending, future interventions should be focused on preventing the incidence of multimorbidity and optimizing the care of elderly adults living with multimorbidity.

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