Multimorbidity and healthcare resource utilization in Switzerland: a multicentre cohort study.

Aubert, Carole E.; Fankhauser, Niklaus; Marques-Vidal, Pedro; Stirnemann, Jérôme; Aujesky, Drahomir; Limacher, Andreas; Donzé, Jacques (2019). Multimorbidity and healthcare resource utilization in Switzerland: a multicentre cohort study. BMC health services research, 19(1), p. 708. BioMed Central 10.1186/s12913-019-4575-2

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BACKGROUND Multimorbidity is associated with higher healthcare resource utilization, but we lack data on the association of specific combinations of comorbidities with healthcare resource utilization. We aimed to identify the combinations of comorbidities associated with high healthcare resource utilization among multimorbid medical inpatients. METHODS We performed a multicentre retrospective cohort study including 33,871 multimorbid (≥2 chronic diseases) medical inpatients discharged from three Swiss hospitals in 2010-2011. Healthcare resource utilization was measured as 30-day potentially avoidable readmission (PAR), prolonged length of stay (LOS) and difference in median LOS. We identified the combinations of chronic comorbidities associated with the highest healthcare resource utilization and quantified this association using regression techniques. RESULTS Three-fourths of the combinations with the strongest association with PAR included chronic kidney disease. Acute and unspecified renal failure combined with solid malignancy was most strongly associated with PAR (OR 2.64, 95%CI 1.79;3.90). Miscellaneous mental health disorders combined with mood disorders was the most strongly associated with LOS (difference in median LOS: 17 days) and prolonged LOS (OR 10.77, 95%CI 8.38;13.84). The number of chronic diseases was strongly associated with prolonged LOS (OR 9.07, 95%CI 8.04;10.24 for ≥10 chronic diseases), and to a lesser extent with PAR (OR 2.16, 95%CI 1.75;2.65 for ≥10 chronic diseases). CONCLUSIONS Multimorbidity appears to have a higher impact on LOS than on PAR. Combinations of comorbidities most strongly associated with healthcare utilization included kidney disorders for PAR, and mental health disorders for LOS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Aubert, Carole Elodie; Fankhauser, Niklaus; Aujesky, Drahomir; Limacher, Andreas and Donzé, Jacques

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1472-6963

Publisher:

BioMed Central

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

21 Oct 2019 14:56

Last Modified:

28 Oct 2019 11:53

Publisher DOI:

10.1186/s12913-019-4575-2

PubMed ID:

31623664

Uncontrolled Keywords:

Chronic diseases Combinations Comorbidity Healthcare utilization Length of stay Multimorbidity Potentially avoidable readmission Readmission

BORIS DOI:

10.7892/boris.134087

URI:

https://boris.unibe.ch/id/eprint/134087

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