S.Y.TAN1, K.W.LEW2, Y.XIE2, P.S.LEE2, H.L.KOH2, E.S.LEE2
NHG Polyclinics1, NHGPHQ2
The rising prevalence of multiple chronic diseases is an important public health issue as it is associated with increase healthcare utilisation. This paper aimed to explore the annual per capita healthcare cost in primary care for patients with multiple chronic diseases i.e. multimorbidity.
This was a retrospective cohort study conducted in a cluster of public primary care clinics in Singapore. De-identified data from electronic medical records were extracted from the period July 2015 to June 2017. Only patients with at least one chronic disease were included in the study. Basic demographic data and healthcare cost were extracted. A list of 20 chronic diseases was considered for multimorbidity.
There were 254,377 patients in our study population of which 52.8% were female. The prevalence of multimorbidity was 62.4%. The median annual healthcare cost per capita for patients with multimorbidity was about twice the amount compared to those without multimorbidity (SGD$683 vs SGD$344). The greatest percentage increment in cost was when the number of chronic diseases increased from two to three (43.0%).
Multimorbidity is associated with higher healthcare cost in primary care. Since evidence for the optimal management of multimorbidity is still elusive, prevention or delay in the onset of multimorbidity in the general population is paramount.