Rapidly increasing multimorbidity results in increase of health care costs

BACKGROUND: Ageing of the population increases the prevalence and co-existence of many chronic diseases, i.e. multimorbidity. In Finland, information on the significance of multimorbidity and its relation to healthcare capacity is scarce. We aimed to study the prevalence of multimorbidity, the transitions between patient groups with and without multiple diseases and associated healthcare cost in 2017-2019. METHODS: The study cohort includes all adults (≥18 yrs) who used Finnish primary or specialized healthcare services in 2017. Multimorbidity status (non-multimorbid, multimorbid or multimorbid at risk) at baseline was determined based on the recordings of a diagnosis of interest using Finnish Care Register data from the year's 2015-2017. The costs were calculated using the care related patient grouping and national standard prices. Transition plots were drawn to observe the transition of patients and costs between different multimorbidity categories during two-year follow-up. RESULTS: Of 3,201,276 patients, 59% were non-multimorbid, 25% multimorbid and 16% multimorbid at risk in 2017. During the follow-up, we found a considerable number of patients moving from non-multimorbid group both to multimorbid and multimorbid at risk -groups. In 2019, 38% of patients were non-multimorbid, 31% were multimorbid, and 28% were multimorbid at risk of poor outcomes, and 3% had died. The proportion of multimorbid patients at risk increased the most in two years. The healthcare cost depended on the severity of multimorbidity. The total healthcare costs were the lowest among non-multimorbid patients and the highest among multimorbid patients at risk, costing 5660 million euros and accounting for 66,8% of total healthcare cost of this patient cohort in 2019. DISCUSSION: Multimorbidity, especially multimorbid patients at risk, is causing a heavy burden and costs for Finnish healthcare. The estimates on its effect on health care usage and costs should be used to guide healthcare planning. KEY MESSAGES: • The number of multimorbid patients, especially those at risk, is increasing fast. • Interventions for improving the prevention and care of multimorbidity are urgently needed.