Understanding the relationship between multimorbidity in later life, use of health services and costs of health care
The effective management of multimorbidity, generally defined as two or more health conditions, is a major challenge for the NHS with substantial implications for NHS resources, especially in view of the rising numbers of older people.
The aim of the study is to understand how use of health services by older people (aged 50 and over) and associated costs of health care rise with each additional health condition. This is intended to help the NHS to target resources toward those older patients who are most likely to have high use of services in future due to multimorbidity.
Our research questions include:
- how much annual costs of health care among older people with multimorbidity vary with the number of comorbidities,
- how much the costs over an eight year period vary with the number of health conditions at the start of the period,
- whether the increase in costs for each additional condition differ by age, gender, deprivation and specific health condition (dementia, depression),
- what are the annual transition rates, by age, gender and deprivation, between morbidity categories defined by number of conditions.
We will address these questions through multivariate analyses of a 100,000 patient sample of Clinical Practice Research Datalink data linked to Hospital Episode Statistics. We will develop a Markov model, using our estimated transition rates and estimated costs of care by number of health conditions, to estimate expected lifetime costs of health care from age 50 upward.
We will develop a user-friendly tool to help the NHS to understand how costs of health care for an individual may be expected to rise over time with additional health conditions. The outputs of the study will be the tool with a user guide, a plain English summary of our findings and articles for professional and academic journals.
Project lead:
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Raphael Wittenberg
Deputy Director, Centre for Health Service Economics and Organisation
Collaborators:
Catia Nicodemo, University of Oxford
Stuart Redding, University of Oxford
Chris Salisbury, University of Bristol
Kamal Mahtani, University of Oxford
Clare Bankhead, University of Oxford
Rafael Perera, University of Oxford
Peter Bower, University of Manchester
Dates:
September 2018 – March 2021
Funder:
National Institute for Health Research School for Primary Care Research
Our team
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Stavros Petrou
Academic Research Lead in Health Economics
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Lucy Abel
Health Economist, DPhil student
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Felix Achana
Senior Researcher in Health Economics
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Laura Armitage
Wellcome Trust Doctoral Research Fellow
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Corneliu Bolbocean
Senior Researcher in Health Economics
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Laia Bosque Mercader
Research Fellow in Health Economics
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Lin Bowker-Lonnecker
DPhil Student
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John Buckell
Researcher
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Padraig Dixon
Senior Researcher in Health Economics
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Patrick Fahr
Quantitative Researcher
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Carmen Fierro Martinez
NIHR Pre-Doctoral Fellow
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Nadeem Hussein
NIHR Pre-Doctoral Fellow
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Joseph Kwon
Researcher in Health Economics
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Sungwook Kim
Senior researcher in Health Economics
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Joan Madia
Researcher in Health Economics
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Joaquim Vidiella Martin
Researcher in Economics
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Catia Nicodemo
Senior Research Fellow in Health Economics
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Olu Onyimadu
Health Economist, DPhil Candidate
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May Png
Senior Researcher in Health Economics
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Stuart Redding
Project Lead, Centre for Health Service Economics & Organisation
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Elizabeth-Ann Schroeder
Senior Researcher in Health Economics
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Raphael Wittenberg
Deputy Director, Centre for Health Service Economics and Organisation
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Yaling Yang
Senior Researcher in Health Economics