The impact of multimorbidity on the use of resources in primary care

1. To investigate whether multimorbidity in primary care patients leads to a greater or lesser use of resources compared to a number of individual patients each with one condition i.e. does ‘multimorbidity’ carry a cost or are there ‘economies of scale’ present?

The stages of analysis were:

• Estimate patient level multimorbidity using a selection of different measures

• Relate each of these to patient level primary care cost controlling for age and gender 

• Identify the measure of multimorbidity that best reflects resource use in primary care

• Investigate the nature of the relationship between multimorbidity and cost using deprivation regression analysis

2. To investigate all two-way combinations of chronic conditions in the QOF to identify whether each is.

The stages of analysis were:

• Using the results of the analysis of part 1, compare the cost of all possible pairs of QOF

• Identify disease combinations that are ‘cost-increasing’ and explore possible reasons

• Identify disease combinations that are ‘cost-decreasing’ and explore possible reasons conditions with the cost of caring for two patients each with one of the two conditions

Publication:

Brilleman S, Purdy S, Salisbury C, Windmeijer F, Gravelle H, Hollinghurst S. Implications of comorbidity for UK primary care costs: a retrospective observational study. British Journal of General Practice. 2013. http://dx.doi.org/10.3399/bjgp13X665242