Cargando…

Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association

Although the economic burden of multimorbidity is a growing global challenge, the contribution of multimorbidity in patients with high medical expenses remains unclear. We aimed to clarify multimorbidity patterns that have a large impact on medical costs in the Japanese population. We conducted a cr...

Descripción completa

Detalles Bibliográficos
Autores principales: Nishida, Yuki, Anzai, Tatsuhiko, Takahashi, Kunihiko, Kozuma, Takahide, Kanda, Eiichiro, Yamauchi, Keita, Katsukawa, Fuminori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538783/
https://www.ncbi.nlm.nih.gov/pubmed/37768909
http://dx.doi.org/10.1371/journal.pone.0291554
_version_ 1785113375079923712
author Nishida, Yuki
Anzai, Tatsuhiko
Takahashi, Kunihiko
Kozuma, Takahide
Kanda, Eiichiro
Yamauchi, Keita
Katsukawa, Fuminori
author_facet Nishida, Yuki
Anzai, Tatsuhiko
Takahashi, Kunihiko
Kozuma, Takahide
Kanda, Eiichiro
Yamauchi, Keita
Katsukawa, Fuminori
author_sort Nishida, Yuki
collection PubMed
description Although the economic burden of multimorbidity is a growing global challenge, the contribution of multimorbidity in patients with high medical expenses remains unclear. We aimed to clarify multimorbidity patterns that have a large impact on medical costs in the Japanese population. We conducted a cross-sectional study using health insurance claims data provided by the Japan Health Insurance Association. Latent class analysis (LCA) was used to identify multimorbidity patterns in 1,698,902 patients who had the top 10% of total medical costs in 2015. The present parameters of the LCA model included 68 disease labels that were frequent among this population. Moreover, subgroup analysis was performed using a generalized linear model (GLM) to assess the factors influencing annual medical cost and 5-year mortality. As a result of obtaining 30 latent classes, the kidney disease class required the most expensive cost per capita, while the highest portion (28.6%) of the total medical cost was spent on metabolic syndrome (MetS) classes, which were characterized by hypertension, dyslipidemia, and type 2 diabetes. GLM applied to patients with MetS classes showed that cardiovascular diseases or complex conditions, including malignancies, were powerful determinants of medical cost and mortality. MetS was classified into 7 classes based on real-world data and accounts for a large portion of the total medical costs. MetS classes with cardiovascular diseases or complex conditions, including malignancies, have a significant impact on medical costs and mortality.
format Online
Article
Text
id pubmed-10538783
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-105387832023-09-29 Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association Nishida, Yuki Anzai, Tatsuhiko Takahashi, Kunihiko Kozuma, Takahide Kanda, Eiichiro Yamauchi, Keita Katsukawa, Fuminori PLoS One Research Article Although the economic burden of multimorbidity is a growing global challenge, the contribution of multimorbidity in patients with high medical expenses remains unclear. We aimed to clarify multimorbidity patterns that have a large impact on medical costs in the Japanese population. We conducted a cross-sectional study using health insurance claims data provided by the Japan Health Insurance Association. Latent class analysis (LCA) was used to identify multimorbidity patterns in 1,698,902 patients who had the top 10% of total medical costs in 2015. The present parameters of the LCA model included 68 disease labels that were frequent among this population. Moreover, subgroup analysis was performed using a generalized linear model (GLM) to assess the factors influencing annual medical cost and 5-year mortality. As a result of obtaining 30 latent classes, the kidney disease class required the most expensive cost per capita, while the highest portion (28.6%) of the total medical cost was spent on metabolic syndrome (MetS) classes, which were characterized by hypertension, dyslipidemia, and type 2 diabetes. GLM applied to patients with MetS classes showed that cardiovascular diseases or complex conditions, including malignancies, were powerful determinants of medical cost and mortality. MetS was classified into 7 classes based on real-world data and accounts for a large portion of the total medical costs. MetS classes with cardiovascular diseases or complex conditions, including malignancies, have a significant impact on medical costs and mortality. Public Library of Science 2023-09-28 /pmc/articles/PMC10538783/ /pubmed/37768909 http://dx.doi.org/10.1371/journal.pone.0291554 Text en © 2023 Nishida et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Nishida, Yuki
Anzai, Tatsuhiko
Takahashi, Kunihiko
Kozuma, Takahide
Kanda, Eiichiro
Yamauchi, Keita
Katsukawa, Fuminori
Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association
title Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association
title_full Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association
title_fullStr Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association
title_full_unstemmed Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association
title_short Multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of Japan Health Insurance Association
title_sort multimorbidity patterns in the working age population with the top 10% medical cost from exhaustive insurance claims data of japan health insurance association
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538783/
https://www.ncbi.nlm.nih.gov/pubmed/37768909
http://dx.doi.org/10.1371/journal.pone.0291554
work_keys_str_mv AT nishidayuki multimorbiditypatternsintheworkingagepopulationwiththetop10medicalcostfromexhaustiveinsuranceclaimsdataofjapanhealthinsuranceassociation
AT anzaitatsuhiko multimorbiditypatternsintheworkingagepopulationwiththetop10medicalcostfromexhaustiveinsuranceclaimsdataofjapanhealthinsuranceassociation
AT takahashikunihiko multimorbiditypatternsintheworkingagepopulationwiththetop10medicalcostfromexhaustiveinsuranceclaimsdataofjapanhealthinsuranceassociation
AT kozumatakahide multimorbiditypatternsintheworkingagepopulationwiththetop10medicalcostfromexhaustiveinsuranceclaimsdataofjapanhealthinsuranceassociation
AT kandaeiichiro multimorbiditypatternsintheworkingagepopulationwiththetop10medicalcostfromexhaustiveinsuranceclaimsdataofjapanhealthinsuranceassociation
AT yamauchikeita multimorbiditypatternsintheworkingagepopulationwiththetop10medicalcostfromexhaustiveinsuranceclaimsdataofjapanhealthinsuranceassociation
AT katsukawafuminori multimorbiditypatternsintheworkingagepopulationwiththetop10medicalcostfromexhaustiveinsuranceclaimsdataofjapanhealthinsuranceassociation