Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

Laura Nedzinskienė, Elena Jurevičienė, Žydrūnė Visockienė, Agnė Ulytė, Roma Puronaitė, Vytautas Kasiulevičius, Edita Kazėnaitė, Greta Burneikaitė and Rokas Navickas
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Laura Nedzinskienė: Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania
Elena Jurevičienė: Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania
Žydrūnė Visockienė: Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania
Agnė Ulytė: Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
Roma Puronaitė: Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania
Vytautas Kasiulevičius: Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania
Edita Kazėnaitė: Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania
Greta Burneikaitė: Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania
Rokas Navickas: Faculty of Medicine, Vilnius University, Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania

IJERPH, 2021, vol. 18, issue 5, 1-12

Abstract: Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

Keywords: care costs; patients with multimorbidity; Lithuania (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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