Hospital Utilization, Costs, and Mortality for Adults With Multiple Chronic Conditions, Nationwide Inpatient Sample, 2009
Open accessAbstract
OBJECTIVE: Our objective was to provide a national estimate across all payers of the distribution and cost of selected chronic conditions for hospitalized adults in 2009, stratified by demographic characteristics. ANALYSIS: We analyzed the Nationwide Inpatient Sample (NIS), the largest all-payer inpatient database in the United States. Use, cost, and mortality estimates across payer, age, sex, and race/ethnicity are produced for grouped or multiple chronic conditions (MCC). The 5 most common dyads and triads were determined. RESULTS: In 2009, there were approximately 28 million adult discharges from US hospitals other than those related to pregnancy and maternity; 39% had 2 to 3 MCC, and 33% had 4 or more. A higher number of MCC was associated with higher mortality, use of services, and average cost. The percentages of Medicaid, privately insured patients, and ethnic/racial groups with 4 or more MCC were highly sensitive to age. SUMMARY: This descriptive analysis of multipayer inpatient data provides a robust national view of the substantial use and costs among adults hospitalized with MCC.
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Polymorbidity affects more than 70% of the hospitalized adult population.
“Polymorbidity is highly prevalent, affecting more than 70% of the hospitalized adult population, and is associated with higher mortality and healthcare burden [10].”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [10]
The Abstract Results report that 39% of adult discharges had 2–3 chronic conditions and 33% had 4 or more—72% combined—but exclude pregnancy- and maternity-related discharges. The Summary says nearly 66% of all adult discharges had two or more chronic conditions. Thus, the claim's unqualified figure of more than 70% for the hospitalized adult population overstates the paper's broader estimate; the paper also measures discharges rather than unique people. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPolymorbidity is associated with higher mortality and healthcare burden.
“Polymorbidity is highly prevalent, affecting more than 70% of the hospitalized adult population, and is associated with higher mortality and healthcare burden [10].”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [10]
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Research works printed but not linked: 3
- [2]Friedman B, Jiang J, Elixhauser A, Segal A. Hospital inpatient costs for adults with multiple chronic conditions. Med Care Res Rev 2006; 63(3): 327– 46. 16651396
- [3]Friedman B, Jiang J, Elixhauser A. Costly hospital readmissions and complex chronic illness. Inquiry 2008-2009; 45(4): 408– 21. 19209836
- [7]Goodman RA, Posner SF, Huang ES, Parekh AK, Koh HK. Defining and measuring chronic conditions: imperatives for research, policy, program and practice. Prev Chronic Dis 2013; 10: 120239. PMC3652713 23618546
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Burke, L. E., Ma, J., Azar, K. M. J., Bennett, G. G., Peterson, E. D., Zheng, Y., Riley, W., Stephens, J., Shah, S. H., Suffoletto, B., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000232 · Cited by 516 · see citing works
ESPEN guidelines on nutritional support for polymorbid internal medicine patients
Gomes, F., Schuetz, P., Bounoure, L., Austin, P., Ballesteros-Pomar, M., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., Poulia, K.-A., et al. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2017.06.025 · Cited by 363 · see citing works
St Sauver, J. L., Boyd, C. M., Grossardt, B. R., Bobo, W. V., Finney Rutten, L. J., Roger, V. L., Ebbert, J. O., Therneau, T. M., Yawn, B. P., & Rocca, W. A. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-006413 · Cited by 257 · see citing works
ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“Polymorbidity is highly prevalent, affecting more than 70% of the hospitalized adult population, and is associated with higher mortality and healthcare burden [10].”
- Authors
- Steiner, C. A., & Friedman, B.
- Affiliations
- Agency for Healthcare Research and Quality (US)
- Corresponding author
- Steiner, Claudia A.
- Venue
- Preventing Chronic Disease
- Published
- 2013-04-25
- Volume
- 10
- Pages
- E62-E62
- ISSN
- 1545-1151 (ISSN-L)
- PMC
- PMC3652722
- OpenAlex
- W1983848589
- Cited by
- 118
- References
- 0
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 2 · 2023: 7 · 2022: 7 · 2021: 8 · 2020: 7 · 2019: 13 · 2018: 7 · 2017: 13 · 2016: 16 · 2015: 17 · 2014: 10 · 2013: 3
- FWCI
- 11.19
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- public-domain
- Locations
- Preventing Chronic Disease (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- multimorbidity, hospital utilization, hospital costs, mortality, hospitalized adults, Medicaid, private insurance, racial and ethnic disparities, age differences, National Inpatient Sample
- MeSH terms
- Adult, Female, Humans, Health Knowledge, Attitudes, Practice, Social Support, Colorectal Neoplasms, Intention
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