The impact of multimorbidity on the use of resources in primary care

The overall aim of this study was to investigate the relationship between multimorbidity and use of healthcare resources in the UK. There were two parts to this analysis:

1. To investigate whether multimorbidity in primary care patients leads to a greater or lesser use of resources compared to a number of individual patients each with one condition i.e. does ‘multimorbidity’ carry a cost or are there ‘economies of scale’ present?

The stages of analysis were:

• Estimate patient level multimorbidity using a selection of different measures

• Relate each of these to patient level primary care cost controlling for age and gender 

• Identify the measure of multimorbidity that best reflects resource use in primary care

• Investigate the nature of the relationship between multimorbidity and cost using deprivation regression analysis

 

2. To investigate all two-way combinations of chronic conditions in the QOF to identify whether each is.

The stages of analysis were:

• Using the results of the analysis of part 1, compare the cost of all possible pairs of QOF

• Identify disease combinations that are ‘cost-increasing’ and explore possible reasons

• Identify disease combinations that are ‘cost-decreasing’ and explore possible reasons conditions with the cost of caring for two patients each with one of the two conditions

 

Publication:

Brilleman S, Purdy S, Salisbury C, Windmeijer F, Gravelle H, Hollinghurst S. Implications of comorbidity for UK primary care costs: a retrospective observational study. British Journal of General Practice. 2013. http://dx.doi.org/10.3399/bjgp13X665242