scholarly journals Utilizing population-based clinical and administrative data to estimate the incremental healthcare costs of dementia and frailty among community-residing care recipients.

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Luke Mondor ◽  
Colleen Maxwell ◽  
Susan Bronskill ◽  
Michael Campitelli ◽  
David Hogan ◽  
...  
Keyword(s):  
Home Care ◽  
Administrative Data ◽  
Clinical Assessment ◽  
Healthcare Costs ◽  
Frailty Index ◽  
Population Based ◽  
Administrative Databases ◽  
Care Recipients ◽  
Bidirectional Association ◽  
Informal Care Costs

IntroductionCurrent cost estimates for dementia in Canada are lacking and no studies have yet to examine the incremental healthcare costs associated with both dementia and frailty, despite evidence of increasing prevalence of both conditions and their bidirectional association. These data are essential for informed clinical and public policy programs. Objectives and ApproachUsing linked clinical and health administrative databases in Ontario, we conducted a cohort study of all long-stay home care clients aged 50+ years with a clinical assessment between April 2014 and March 2015 (n=160,209). We defined dementia using a validated algorithm, and frailty categories (robust, pre-frail, frail) using a modified frailty index from clinical assessment data. Clients were followed prospectively for 1-year, for which we obtained total- and sector-specific healthcare costs for all encounters. We calculated cost differences (in $2015CAD) between dementia-frailty groups using a survival- and covariate-adjusted cost estimator described by Manning and Basu (2010) that included dementia-frailty interactions. ResultsIn this population-based cohort of long-stay home care recipients, the prevalence of dementia was 26.8% and 33.3% of these clients were frail (vs. 26.9% among clients without dementia). Approximately 15% of the cohort died over the 1-year follow-up. The average 1-year estimated total health system cost was $26,965. On average, home care clients with dementia categorized as frail incurred $14,291 (SE=$139) more in charges than similar robust clients ($35,381 vs. $21,091, respectively). In contrast, frail persons without dementia incurred $12,796 (SE=$95) more in charges that similar robust clients ($33,659 vs. $20,864, respectively). Among frail persons, those with dementia incurred $1,722 (SE=$149) more in expenditures, on average. Wide variation in sector-specific costs were also observed by dementia and frailty strata. Conclusion/ImplicationsDementia and frailty pose significant challenges to healthcare systems. Our findings illustrate large incremental costs associated with frailty, regardless of dementia status. Further research using the linked clinical assessment and administrative data is needed to inform variations in, and to delineate key drivers of, formal healthcare and informal care costs associated with dementia and frailty.

scholarly journals Joint impact of dementia and frailty on healthcare utilisation and outcomes: a retrospective cohort study of long-stay home care recipients

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e029523 ◽  
Author(s):  
Colleen J Maxwell ◽  
Luke Mondor ◽  
David B Hogan ◽  
Michael A Campitelli ◽  
Susan E Bronskill ◽  
...  
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Frailty Index ◽  
Cox Proportional Hazards ◽  
Administrative Databases ◽  
Term Care ◽  
Care Recipients ◽  
The Impact

ObjectivesTo examine the associations between dementia and 1-year health outcomes (urgent hospitalisation, long-term care (LTC) admission, mortality) among long-stay home care recipients and the extent to which these associations vary by clients’ frailty level.DesignA retrospective cohort study using linked clinical and health administrative databases.SettingHome care in Ontario, Canada.ParticipantsLong-stay (≥60 days) care clients (n=153 125) aged ≥50 years assessed between April 2014 and March 2015.Main outcome measuresDementia was ascertained with a validated administrative data algorithm and frailty with a 66-item frailty index (FI) based on a previously validated FI derived from the clinical assessment. We examined associations between dementia, FI and their interactions, with 1-year outcomes using multivariable Fine-Gray competing risk (urgent hospitalisation and LTC admission) and Cox proportional hazards (mortality) models.ResultsClients with dementia (vs without) were older (mean±SD, 83.3±7.9 vs 78.9±11.3 years, p<0.001) and more likely to be frail (30.3% vs 24.2%, p<0.001). In models adjusted for FI (as a continuous variable) and other confounders, clients with dementia showed a lower incidence of urgent hospitalisation (adjusted subdistribution HR (sHR)=0.84, 95% CI: 0.83 to 0.86) and mortality rate (adjusted HR=0.87, 95% CI: 0.84 to 0.89) but higher incidence of LTC admission (adjusted sHR=2.60, 95% CI: 2.53 to 2.67). The impact of dementia on LTC admission and mortality was significantly modified by clients’ FI (p<0.001 interaction terms), showing a lower magnitude of association (ie, attenuated positive (for LTC admission) and negative (for mortality) association) with increasing frailty.ConclusionsThe strength of associations between dementia and LTC admission and death (but not urgent hospitalisation) among home care recipients was significantly modified by their frailty status. Understanding the public health impact of dementia requires consideration of frailty levels among older populations, including those with and without dementia and varying degrees of multimorbidity.

Epidemiology of pheochromocytoma and paraganglioma: population-based cohort study

2021 ◽  
Vol 184 (1) ◽  
pp. 19-28
Author(s):  
Alexander A Leung ◽  
Janice L Pasieka ◽  
Martin D Hyrcza ◽  
Danièle Pacaud ◽  
Yuan Dong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Administrative Data ◽  
Laboratory Data ◽  
Population Based ◽  
Incidence Rates ◽  
Primary Objective ◽  
Administrative Databases ◽  
Secondary Objective ◽  
True Frequency ◽  
Clinical Records

Objective Despite the significant morbidity and mortality associated with pheochromocytoma and paraganglioma, little is known about their epidemiology. The primary objective was to determine the incidence of pheochromocytoma and paraganglioma in an ethnically diverse population. A secondary objective was to develop and validate algorithms for case detection using laboratory and administrative data. Design Population-based cohort study in Alberta, Canada from 2012 to 2019. Methods Patients with pheochromocytoma or paraganglioma were identified using linked administrative databases and clinical records. Annual incidence rates per 100 000 people were calculated and stratified according to age and sex. Algorithms to identify pheochromocytoma and paraganglioma, based on laboratory and administrative data, were evaluated. Results A total of 239 patients with pheochromocytoma or paraganglioma (collectively with 251 tumors) were identified from a population of 5 196 368 people over a period of 7 years. The overall incidence of pheochromocytoma or paraganglioma was 0.66 cases per 100 000 people per year. The frequency of pheochromocytoma and paraganglioma increased with age and was highest in individuals aged 60–79 years (8.85 and 14.68 cases per 100 000 people per year for males and females, respectively). An algorithm based on laboratory data (metanephrine >two-fold or normetanephrine >three-fold higher than the upper limit of normal) closely approximated the true frequency of pheochromocytoma and paraganglioma with an estimated incidence of 0.54 cases per 100 000 people per year. Conslusion The incidence of pheochromocytoma and paraganglioma in an unselected population of western Canada was unexpectedly higher than rates reported from other areas of the world.

scholarly journals Validation of Carotid Artery Revascularization Coding in Ontario Health Administrative Databases

2016 ◽  
Vol 39 (2) ◽  
pp. 73 ◽  
Author(s):  
Mohamad A Hussain ◽  
Muhammad Mamdani ◽  
Gustavo Saposnik ◽  
Jack V Tu ◽  
David Turkel-Parrella ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Administrative Data ◽  
High Volume ◽  
Population Based ◽  
Administrative Databases ◽  
Ontario Health Insurance Plan ◽  
Stroke Registry ◽  
Administrative Records ◽  
Ischemic Attack ◽  
Procedure Codes

Purpose: The positive predictive value (PPV) of carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedure and post-operative complication coding were assessed in Ontario health administrative databases. Methods: Between 1 April 2002 and 31 March 2014, a random sample of 428 patients were identified using Canadian Classification of Health Intervention (CCI) procedure codes and Ontario Health Insurance Plan (OHIP) billing codes from administrative data. A blinded chart review was conducted at two high-volume vascular centers to assess the level of agreement between the administrative records and the corresponding patients’ hospital charts. PPV was calculated with 95% confidence intervals (CIs) to estimate the validity of CEA and CAS coding, utilizing hospital charts as the gold standard. Sensitivity of CEA and CAS coding were also assessed by linking two independent databases of 540 CEA-treated patients (Ontario Stroke Registry) and 140 CAS-treated patients (single-center CAS database) to administrative records. Results: PPV for CEA ranged from 99% to 100% and sensitivity ranged from 81.5% to 89.6% using CCI and OHIP codes. A CCI code with a PPV of 87% (95% CI, 78.8-92.9) and sensitivity of 92.9% (95% CI, 87.4-96.1) in identifying CAS was also identified. PPV for post-admission complication diagnosis coding was 71.4% (95% CI, 53.7-85.4) for stroke/transient ischemic attack, and 82.4% (95% CI, 56.6-96.2) for myocardial infarction. Conclusions: Our analysis demonstrated that the codes used in administrative databases accurately identify CEA and CAS-treated patients. Researchers can confidently use administrative data to conduct population-based studies of CEA and CAS.

scholarly journals LO13: Characteristics of emergency department visits by community-dwelling older adults who screened positive for elder abuse during home care assessments

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S11 ◽  
Author(s):  
E. Mercier ◽  
A. Jones ◽  
A. Brousseau ◽  
J. Hirdes ◽  
F. Mowbray ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Reporting System ◽  
Elder Abuse ◽  
Frailty Index ◽  
Population Based ◽  
Community Dwelling ◽  
Care Assessment ◽  
Ed Visits ◽  
Community Dwelling Older Adults

Introduction: Elder abuse is infrequently detected in the emergency department (ED) and less than 2% are reported to proper law authorities by ED physicians. This study aims to examine the characteristics of community-dwelling older adults who screened positive for elder abuse during home care assessments and the epidemiology of ED visits by these patients relative to other home care patients. Methods: This study utilized a population-based retrospective cohort study of home care patients in Canada between April 1, 2007 and March 31, 2015. Standardized, comprehensive home care assessments were extracted from the Home Care Reporting System. A positive screen for elder abuse was defined as at least one these criteria: fearful of a caregiver; unusually poor hygiene; unexplained injuries; or neglected, abused, or mistreated. Home care assessments were linked to the National Ambulatory Care Reporting System in the regions and time periods in which population-based estimates could be obtained to identify all ED visits within 6 months of the home care assessment. Results: A total of 30,413 from the 2,401,492 patients (1.3%) screened positive for elder abuse during a home care assessment. They were more likely to be male (40.5% versus 35.3%, p &lt; 0.001), to have a cognitive impairment (82.9% versus 65.3%, p &lt; 0.001), a higher frailty index (0.27 versus 0.22, p &lt; 0.001) and to exhibit more depressive symptoms (depression rating scale 1 or more: 68.7% versus 42.7%, p &lt; 0.001). Patient who screened positive for elder abuse were less likely to be independent in activities of daily living (41.9% versus 52.7%, p &lt; 0.001) and reported having fallen more frequently (44.2% versus 35.5%, p &lt; 0.001). Caregiver expressing distress was associated with elder abuse (35.3% versus 18.3%, p &lt; 0.001) but not a higher number of hours caring for the patient. Victims of elder abuse were more likely to attend the ED for low acuity conditions (Canadian triage and acuity scale (CTAS) 4 or 5). Diagnosis at discharge from ED were similar with the exception of acute intoxication that was more frequent in patients who are victims of abuse. Conclusion: Elder abuse is infrequently detected during home care assessments in community-dwelling older adults. Higher frailty index, cognitive impairment, depressive symptoms were associated with elder abuse during homecare assessments. Patients who are victims of elder abuse are attending EDs more frequently for low acuity conditions but ED diagnosis at discharge, except for acute intoxication, are similar.

scholarly journals Validation of endovascular and open thoracoabdominal aortic aneurysm repair in Ontario health administrative databases

2019 ◽  
Vol 42 (2) ◽  
pp. E19-25 ◽  
Author(s):  
Rodolfo V. Rocha ◽  
Mohammed Al-Omran ◽  
Mohamad A. Hussain ◽  
Douglas S. Lee ◽  
Thomas L. Forbes ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Administrative Data ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Population Based ◽  
Administrative Databases ◽  
Ontario Health Insurance Plan ◽  
Administrative Records ◽  
Thoracoabdominal Aortic Aneurysm Repair ◽  
Aneurysm Repair ◽  
Procedure Codes

Purpose: The positive predictive value (PPV) of endovascular and open thoracoabdominal aortic aneurysm (TAAA) repair coding was assessed in Ontario health administrative databases. Methods: Between 1 January 2006 and 31 March 2016, a random sample of 192 patients was identified using Canadian Classification of Health Intervention (CCI) procedure codes and Ontario Health Insurance Plan (OHIP) billing codes from administrative data. Blinded chart reviews were conducted at two cardiovascular centers to assess the level of agreement between the administrative records and the corresponding patients’ hospital charts. The PPV was calculated with 95% confidence intervals using hospital charts as the gold standard. Results: The PPV for the single endovascular TAAA repair code, 1ID80GQNRN, was 0.90 (0.78, 0.97). A combination of all nine CCI open TAAA repair codes was performed, with a PPV of 0.62 (0.47, 0.76). The combination of any one of the nine CCI codes AND the single OHIP code for open TAAA repair (R803) rendered a PPV of 0.98 (0.90, 1.00). Conclusions: Endovascular TAAA repair may be identified using a single CCI code (1ID80GQNRN). Open TAAA repair may be identified using a combination of CCI and OHIP codes. Researchers may therefore use administrative data to conduct population-based studies of endovascular and open repair of TAAA.

scholarly journals Predicting unplanned hospital visits in older home care recipients: a cross-country external validation study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jet H. Klunder ◽  
Veronique Bordonis ◽  
Martijn W. Heymans ◽  
Henriëtte G. van der Roest ◽  
Anja Declercq ◽  
...  
Keyword(s):  
At Risk ◽  
Home Care ◽  
Hospital Admissions ◽  
Frailty Index ◽  
External Validation ◽  
Risk Scores ◽  
Care Recipients ◽  
Ed Visits ◽  
Hospital Visits ◽  
Unplanned Hospital Admissions

Abstract Background Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores.

Quality indicators for end-of-life breast cancer care: Testing the use of administrative databases

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6066-6066 ◽  
Author(s):  
L. Lethbridge ◽  
E. Grunfeld ◽  
R. Dewar ◽  
G. Johnston ◽  
P. McIntyre ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
End Of Life ◽  
Administrative Data ◽  
Population Based ◽  
Vital Statistics ◽  
Administrative Databases ◽  
Breast Cancer Patients ◽  
Eol Care

6066 Background: Defining, measuring and monitoring quality of care is a facet of health services research that is growing in importance. Breast cancer offers a disease model to examine quality end-of-life (EOL) care provided to women. Administrative data have the unique potential to provide population-based measures of quality of care. The objective of this study was to assess the feasibility of using routinely-collected administrative data to measure quality EOL care for breast cancer patients. Methods: A cohort of all women in Nova Scotia who died of breast cancer between 01/01/1998 and 31/12/2002 was assembled from the Cancer Registry and Vital Statistics data. The EOL study period was defined as the last 6 months of life. A total of 864 women met the eligibility criteria. After a literature review, an expert panel identified 19 indicators that were potentially measurable through administrative data. Physician billings, hospital discharge abstracts and seniors pharmacare data, supplemented by clinical datasets, were utilized to calculate the statistics with which to represent the indicators. Results: Benchmark measures of care across the cohort show 63.4% died in a hospital, a mean continuity of care index of 0.786, and the mean number of inpatient days in the last 30 was 9.9. Indicators of aggressive care include 9.3% had chemotherapy in the last 14 days, 5.6% had more than 1 emergency room visit in the last 30 days, and 29.1% had more than 14 inpatient days in the last 30 days. Conclusions: Weaknesses of using these data include: 1) fixed variables with an administrative rather than a clinical objective; 2) lack of comprehensiveness of various datasets; and 3) the use of billings data where increasingly physicians are paid through methods other than fee-for-service. Strengths of this approach are: 1) population-based cohort; 2) comprehensiveness of cohort selection through the provincial Vital Statistics file; and 3) accessibility of data. No significant financial relationships to disclose.

The validity of algorithms using health administrative data in identifying cancer-related events in adolescents and young adults: A population-based study using the IMPACT cohort.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18168-e18168
Author(s):  
Jason D Pole ◽  
Paul C. Nathan ◽  
Nancy N. Baxter ◽  
Cindy Lau ◽  
Corinne Daly ◽  
...  
Keyword(s):  
Young Adults ◽  
Administrative Data ◽  
Population Based ◽  
Adolescents And Young Adults ◽  
Administrative Databases ◽  
Time Interval ◽  
Cancer Outcomes ◽  
Health Administrative Data ◽  
Chart Abstraction ◽  
The Impact

e18168 Background: Despite the importance of estimating population level cancer outcomes, most registries do not collect critical events such as relapse and progression. Attempts to use health administrative data to identify these events have focused on older adults and have been mostly unsuccessful. We developed and tested administrative data-based algorithms in a population-based cohort of adolescents and young adults (AYA) with cancer. Methods: We identified all Ontario AYA 15-21 years of age diagnosed with leukemia, lymphoma, sarcoma, or testicular cancer between 1992 and 2012. Chart abstraction was used to determine the end of initial treatment (EOIT) date and subsequent cancer-related events (progression, relapse, second cancer). Linkage to population-based administrative databases identified fee and procedure codes indicating cancer treatment or palliative care. Algorithms that determined EOIT based a time interval free of treatment-associated codes, and new cancer-related events based on billing codes, were compared to chart abstracted data. Results: The cohort comprised 1,404 patients. Time periods free of treatment-associated codes did not validly identify EOIT dates; using subsequent codes to identify new cancer events was thus associated with low sensitivity (56.2%). However, using administrative data codes that occurred after the EOIT date based on chart abstraction, the first cancer-related event was identified with excellent validity (sensitivity 87.0%, specificity 93.3%, PPV 81.5%, negative predictive value 95.5%). Conclusions: While administrative data alone did not validly identify cancer-related events, using administrative data in combination with chart collected EOIT dates was associated with excellent validity. The collection of EOIT dates by cancer registries would significantly expand the potential of administrative data linkage to assess cancer outcomes.

Determining the cancer diagnostic interval using administrative data in a cohort of patients with pancreatic ductal adenocarcinoma (PDAC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13551-e13551
Author(s):  
Bailey Paterson ◽  
Shiying Kong ◽  
Alyson Mahar ◽  
Colleen Webber ◽  
Richard M. Lee-Ying ◽  
...  
Keyword(s):  
Administrative Data ◽  
Control Charts ◽  
Population Based ◽  
Administrative Databases ◽  
Interval Length ◽  
Ductal Adenocarcinoma ◽  
Statistical Control ◽  
Wide Range ◽  
Age Of Diagnosis ◽  
Diagnostic Interval

e13551 Background: PDAC is a leading cause of cancer death that is often diagnosed at an advanced stage. Population-based administrative data can be a valuable resource for studying the diagnostic interval, defined as the time from the first related healthcare encounter to cancer diagnosis. The objective of this study was to determine the diagnostic interval in a cohort of patients with PDAC using an empirical approach. Methods: This is a retrospective, cohort study of patients diagnosed with PDAC from 2007 – 2015 in Alberta, Canada. We used the Alberta Cancer Registry, physician billing claims, hospital discharge and emergency room visits to identify and categorize cancer-related healthcare encounters before diagnosis. We used statistical control charts to define the lookback period for each encounter category and used these lookback periods to identify the earliest encounter that represented the start of the diagnostic interval (index contact date). The end of the interval was the diagnosis date. Quantile regression was used to determine factors associated with the diagnostic interval. Results: We identified 3,142 patients with PDAC. Median age of diagnosis was 71 (IQR 61-80). We identified an index contact date and thus a diagnostic interval in 96.5% of patients. The median diagnostic interval length was 76 days (IQR 21-191; 90th percentile 276 days). A higher Elixhauser comorbidity score (+18.57 days/ 1 point increase, 95% CI 16.07-21.07, p<0.001) and stage 3 disease compared to stage 2 disease (+22.55 days, 95% CI 5.02-40.08, p=0.01) were associated with a longer diagnostic interval. Conclusions: In this cohort of patients with PDAC, there was a wide range in the diagnostic interval with 10% of patients having a diagnostic interval of approximately 9 months. Diagnostic interval research using administrative databases can understand variations in diagnosis times and can inform early detection efforts by identifying where and in whom delays may occur.

scholarly journals Effect of socio-demographic factors on the association between multimorbidity and healthcare costs: a population-based, retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017264 ◽  
Author(s):  
Kednapa Thavorn ◽  
Colleen J Maxwell ◽  
Andrea Gruneir ◽  
Susan E Bronskill ◽  
YuQing Bai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Healthcare Costs ◽  
Retrospective Cohort ◽  
Demographic Factors ◽  
Positive Association ◽  
Healthcare Services ◽  
Population Based ◽  
Administrative Databases ◽  
Socio Demographic Factors

ObjectivesTo estimate the attributable costs of multimorbidity and assess whether the association between the level of multimorbidity and health system costs varies by socio-demographic factors in young (<65 years) and older (≥65 years) adults living in Ontario, Canada.DesignA population-based, retrospective cohort studySettingThe province of Ontario, CanadaParticipants6 639 089 Ontarians who were diagnosed with at least one of 16 selected medical conditions on 1 April 2009.Main outcome measuresFrom the perspective of the publicly funded healthcare system, total annual healthcare costs were derived from linked provincial health administrative databases using a person-level costing method. We used generalised linear models to examine the association between the level of multimorbidity and healthcare costs and the extent to which socio-demographic variables modified this association.ResultsAttributable total costs of multimorbidity ranged from C$377 to C$2073 for young individuals and C$1026 to C$3831 for older adults. The association between the degree of multimorbidity and healthcare costs was significantly modified by age (p<0.001), sex (p<0.001) and neighbourhood income (p<0.001) in both age groups, and the positive association between healthcare costs and levels of multimorbidity was statistically stronger for older than younger adults. For individuals aged 65 years or younger, the increase in healthcare costs was more gradual in women than in their male counterparts, however, for those aged 65 years or older, the increase in healthcare costs was significantly greater among women than men. Lastly, we also observed that the positive association between the level of multimorbidity and healthcare costs was significantly greater at higher levels of marginalisation.ConclusionSocio-demographic factors are important effect modifiers of the relationship between multimorbidity and healthcare costs and should therefore be considered in any discussion of the implementation of healthcare policies and the organisation of healthcare services aimed at controlling healthcare costs associated with multimorbidity.

Sign in / Sign up

Export Citation Format

Share Document