ArticleMedical care2017
Identifying Specific Combinations of Multimorbidity that Contribute to Health Care Resource Utilization: An Analytic Approach.
Article in Medical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed.
- Symptom management interventions influence unscheduled health services use among cancer survivors and caregivers.Journal of cancer survivorship : research and practice · 2026Trial
- Sociodemographic differences in clinical phenotypes among patients with COPD: a latent class analysis.BMJ open respiratory research · 2026Article
- Higher oxygen content and transport characterize high-altitude ethnic Tibetan women with the highest lifetime reproductive success.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Multimorbidity in Atherosclerotic Cardiovascular Disease and Its Associations With Adverse Cardiovascular Events and Healthcare Costs: A Real-World Evidence Study.Journal of health economics and outcomes research · 2024Article
- Article
- Disparities in adherence and emergency department utilization among people with epilepsy: A machine learning approach.Seizure · 2023Article
- Incremental Health Care Costs of Self-Reported Functional Impairments and Phenotypic Frailty in Community-Dwelling Older Adults : A Prospective Cohort Study.Annals of internal medicine · 2023Article
- Estimating health spending associated with chronic multimorbidity in 2018: An observational study among adults in the United States.PLoS medicine · 2023Observational
- CHRONIC MULTIMORBIDITY OF LOW BACK PAIN OR OTHER CHRONIC BACK DISORDERS IN THE REPUBLIC OF CROATIA.Acta clinica Croatica · 2023Article
- Using hypergraphs to quantify importance of sets of diseases by healthcare resource utilisation: A retrospective cohort study.PloS one · 2023Article
- A named GP increases self-reported access to health care services.BMC health services research · 2022Article
- What if You Need More Than One? More Acute Care Surgery Procedures Are Associated with Mortality.Surgical infections · 2022Article
- The importance of chronic conditions for potentially avoidable hospitalizations among non-Hispanic Black and non-Hispanic White older adults in the US: a cross-sectional observational study.BMC health services research · 2022Observational
- Prevalence of multimorbidity combinations and their association with medical costs and poor health: A population-based study of U.S. adults.Frontiers in public health · 2022Article
- Measuring Multimorbidity: Selecting the Right Instrument for the Purpose and the Data Source.Medical care · 2021Article
- AI and Big Data in Healthcare: Towards a More Comprehensive Research Framework for Multimorbidity.Journal of clinical medicine · 2021Review
- Comparing Multimorbidity Patterns Among Discharged Middle-Aged and Older Inpatients Between Hong Kong and Zurich: A Hierarchical Agglomerative Clustering Analysis of Routine Hospital Records.Frontiers in medicine · 2021Article
- Untangling the complexity of multimorbidity with machine learning.Mechanisms of ageing and development · 2020Review
- Epidemiology of multimorbidity in conditions of extreme poverty: a population-based study of older adults in rural Burkina Faso.BMJ global health · 2020Article
- The Influence of Multimorbidity on Leading Causes of Death in Older Adults With Cognitive Impairment.Journal of aging and health · 2019Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundMultimorbidity affects the majority of elderly adults and is associated with higher health costs and utilization, but how specific patterns of morbidity influence resource use is less understood.
objectiveThe objective was to identify specific combinations of chronic conditions, functional limitations, and geriatric syndromes associated with direct medical costs and inpatient utilization.
designRetrospective cohort study using the Health and Retirement Study (2008-2010) linked to Medicare claims. Analysis used machine-learning techniques: classification and regression trees and random forest. SUBJECTS: A population-based sample of 5771 Medicare-enrolled adults aged 65 and older in the United States. MEASURES: Main covariates: self-reported chronic conditions (measured as none, mild, or severe), geriatric syndromes, and functional limitations. Secondary covariates: demographic, social, economic, behavioral, and health status measures. OUTCOMES: Medicare expenditures in the top quartile and inpatient utilization.
resultsMedian annual expenditures were $4354, and 41% were hospitalized within 2 years. The tree model shows some notable combinations: 64% of those with self-rated poor health plus activities of daily living and instrumental activities of daily living disabilities had expenditures in the top quartile. Inpatient utilization was highest (70%) in those aged 77-83 with mild to severe heart disease plus mild to severe diabetes. Functional limitations were more important than many chronic diseases in explaining resource use.
conclusionsThe multimorbid population is heterogeneous and there is considerable variation in how specific combinations of morbidity influence resource use. Modeling the conjoint effects of chronic conditions, functional limitations, and geriatric syndromes can advance understanding of groups at greatest risk and inform targeted tailored interventions aimed at cost containment.
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