The associations of multimorbidity with the sum of annual medical and long-term care expenditures in Japan

• Published in: BMC geriatrics 2019-03, Vol.19 (1), p.69-69, Article 69
• Main Authors: Mori, Takahiro, Hamada, Shota, Yoshie, Satoru, Jeon, Boyoung, Jin, Xueying, Takahashi, Hideto, Iijima, Katsuya, Ishizaki, Tatsuro, Tamiya, Nanako
• Format: Article
• Language: English
• Subjects: Adults; Aged; Aged, 80 and over; Analysis; Charlson comorbidity index; Chronic diseases; Chronic illnesses; Claims data; Coexistence; Comorbidity; Economic aspects; Female; Geriatrics; Geriatrics - economics; Health care costs; Health Expenditures - statistics & numerical data; Health Surveys; Humans; Insurance; Insurance policies; Insurance, Long-Term Care - economics; Japan - epidemiology; Long term care; Long term care insurance; Long-Term Care - economics; Long-term care expenditures; Male; Medical economics; Medical expenditures; Morbidity; Multimorbidity; Multimorbidity - trends; Older people; Patient outcomes
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-019-1057-7

The occurrence of multimorbidity (i.e., the coexistence of multiple chronic diseases) increases with age in older adults and is a growing concern worldwide. Multimorbidity has been reported to be a driving factor in the increase of medical expenditures in OECD countries. However, to the best of our knowledge, there is no published research that has examined the associations between multimorbidity and either long-term care (LTC) expenditure or the sum of medical and LTC expenditures worldwide. We, therefore, aimed to examine the associations of multimorbidity with the sum of medical and LTC expenditures for older adults in Japan. Medical insurance claims data for adults ≥75 years were merged with LTC insurance claims data from Kashiwa city, a suburb in the Tokyo metropolitan area, for the period between April 2012 and September 2013 to obtain an estimate of medical and LTC expenditures. We also calculated the 2011 updated and reweighted version of the Charlson Comorbidity Index (CCI) scores. Then, we performed multiple generalized linear regressions to examine the associations of CCI scores (0, 1, 2, 3, 4, or ≥ 5) with the sum of annual medical and LTC expenditures, adjusting for age, sex, and household income level. The mean sum of annual medical and LTC expenditures was ¥1,086,000 (US$12,340; n = 30,042). Medical and LTC expenditures accounted for 66 and 34% of the sum, respectively. Every increase in one unit of the CCI scores was associated with a ¥257,000 (US$2920); 95% Confidence Interval: ¥242,000, 271,000 (US$2750, 3080) increase in the sum of the expenditures (p