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A Systematic Review of Cost-of-Illness Studies of Multimorbidity
Open accessAbstract
Objectives The economic burden of multimorbidity is considerable. This review analyzed the methods of cost-of-illness (COI) studies and summarized the economic outcomes of multimorbidity.Methods A systematic review (2000-2016) was performed, which was registered with Prospero, reported according to PRISMA, and used a quality checklist adapted for COI studies. The inclusion criteria were peer-reviewed COI studies on multimorbidity, whereas the exclusion criterion was studies focusing on an index disease. Extracted data included the definition, measure, and prevalence of multimorbidity; the number of included health conditions; the age of study population; the variables used in the COI methodology; the percentage of multimorbidity vs. total costs; and the average costs per capita.Results Among the 26 included articles, 14 defined multimorbidity as a simple count of 2 or more conditions. Methodologies used to derive the costs were markedly different. Given different healthcare systems, OOP payments of multimorbidity varied across countries. In the 17 and 12 studies with cut-offs of ≥2 and ≥3 conditions, respectively, the ratios of multimorbidity to non-multimorbidity costs ranged from 2-16 to 2-10. Among the ten studies that provided cost breakdowns, studies with and without a societal perspective attributed the largest percentage of multimorbidity costs to social care and inpatient care/medicine, respectively.Conclusion Multimorbidity was associated with considerable economic burden. Synthesising the cost of multimorbidity was challenging due to multiple definitions of multimorbidity and heterogeneity in COI methods. Count method was most popular to define multimorbidity. There is consistent evidence that multimorbidity was associated with higher costs.
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Metadata
- Authors
- Wang, L., Si, L., Cocker, F., Palmer, A. J., & Sanderson, K.
- Affiliations
- University of Tasmania (AU)
- University of East Anglia (GB)
- Corresponding author
- Sanderson, Kristy
- Venue
- Applied Health Economics and Health Policy
- Published
- 2017-08-30
- Volume
- 16
- Issue
- 1
- Pages
- 15-29
- ISSN
- 1175-5652 (ISSN-L)
- 1179-1896
- OpenAlex
- W2750674138
- Cited by
- 178
- References
- 70
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 23 · 2023: 25 · 2022: 29 · 2021: 31 · 2020: 32 · 2019: 16 · 2018: 3
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- green
- ueaeprints.uea.ac.uk
- Locations
- Applied Health Economics and Health Policy (publishedVersion)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- RePEc: Research Papers in Economics (acceptedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- UTAS Research Repository (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- multimorbidity, economic burden, out-of-pocket costs, cost breakdown, social care costs, hospital costs, societal perspective, health care costs
- MeSH terms
- Multimorbidity, Health Services Research, Humans, Cost of Illness
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