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

Details

Serval ID
serval:BIB_8A4026AAAD77
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Multimorbidity and healthcare resource utilization in Switzerland: a multicentre cohort study.
Journal
BMC health services research
Author(s)
Aubert C.E., Fankhauser N., Marques-Vidal P., Stirnemann J., Aujesky D., Limacher A., Donzé J.
ISSN
1472-6963 (Electronic)
ISSN-L
1472-6963
Publication state
Published
Issued date
17/10/2019
Peer-reviewed
Oui
Volume
19
Number
1
Pages
708
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: epublish
Abstract
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.
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.
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).
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.
Keywords
Aged, Chronic Disease/epidemiology, Chronic Disease/therapy, Female, Humans, Male, Middle Aged, Multimorbidity, Patient Acceptance of Health Care/statistics & numerical data, Retrospective Studies, Switzerland/epidemiology, Chronic diseases, Combinations, Comorbidity, Healthcare utilization, Length of stay, Potentially avoidable readmission, Readmission
Pubmed
Web of science
Open Access
Yes
Create date
21/10/2019 16:00
Last modification date
22/01/2020 7:19
Usage data