Having two or more non-communicable diseases (multimorbidity) costs the country more than the sum of those individual diseases would cost, according to a recent study published in PLOS Medicine by CEPAR Chief Investigator Professor Philip Clarke and colleagues.
Few studies have estimated disease-specific health system expenditure for many diseases simultaneously. In the new work, the researchers used nationally linked health data for all New Zealanders, including hospitalization, outpatient, pharmaceutical, laboratory and primary care from 2007 through 2014.
Using regression methods, Professor Clarke and co-authors calculated the additional or excess costs per person from having one or more chronic diseases and analysed the association of this spending to whether the person had any of six non-communicable disease classes – cancer, cardiovascular disease, diabetes, musculoskeletal, neurological, and lung/liver/kidney (LLK) diseases – or a combination of any of those diseases. They find nearly a quarter of all NZ health expenditure on chronic non-communicable disease was attributable to costs from having two or more diseases.
“The additional costs from having two or more diseases, over and above the costs of having the disease separately, reinforce the need for policy and planning to anticipate the effects of ageing populations with comorbidity,” said Professor Clarke.
"We found that there is a surprising lack of disease-attributed costing studies involving multiple diseases at once. Governments and health systems managers and funders can improve planning and prioritisation knowing where the money goes."
“We believe the costing methods used in this paper can be applied elsewhere,” said Professor Clarke.
“Our paper and methods may help in that the regression models built within a given country predict the relative expenditure by disease – which could be merged with the population demography, disease epidemiology, and total health expenditure of another country to at least provide an initial costing.”