ArticleBMJ open2022
What is the impact of multimorbidity on out-of-pocket healthcare expenditure among community-dwelling older adults in Ireland? A cross-sectional study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 20 citations in OpenAlex.
- Prevalence and impact of prescribing cascades in community-dwelling adults: Longitudinal analysis of the Irish longitudinal study on ageing (TILDA).British journal of clinical pharmacology · 2026Article
- Analysing the impact of complex multimorbidity on health-related quality of life.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Out-of-pocket expenditures on over-the-counter medications: a cross-sectional study of consumer spending patterns.Frontiers in public health · 2026Article
- Association between socioeconomic status and dispensing of higher-risk drug classes and polypharmacy in older community-based populations: a nationwide cohort study.European journal of clinical pharmacology · 2025Article
- Prevalence of potentially inappropriate prescribing in community-dwelling older adults: an application of STOPP/START version 3 to The Irish Longitudinal Study on Ageing (TILDA).European geriatric medicine · 2025Article
- Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016.Exploratory research in clinical and social pharmacy · 2025Article
- How do people with multimorbidity prioritise healthcare when faced with tighter financial constraints? A national survey with a choice experiment component.BMC primary care · 2025Article
- Assessing the financial burden of multimorbidity among patients aged 30 and above in India.BMC health services research · 2025Article
- Determinants of out-of-pocket expenditure on medicines among adults in Saudi Arabia: a cross-sectional study.Frontiers in medicine · 2024Article
- Exploring the link between Multimorbidity and direct healthcare costs in Ireland: A cross-sectional study.Journal of multimorbidity and comorbidityArticle
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIndividuals with multimorbidity use more health services and take more medicines. This can lead to high out-of-pocket (OOP) healthcare expenditure. This study, therefore, aimed to assess the association between multimorbidity (two or more chronic conditions) and OOP healthcare expenditure in a nationally representative sample of adults aged 50 years or over.
designCross-sectional analysis of data collected in 2016 from wave 4 of The Irish Longitudinal Study on Ageing.
resultsOverall, 3453 (58.5%) participants had multimorbidity. Among those with any OOP healthcare expenditure, individuals with multimorbidity spent more on average per annum (€806.8 for two conditions, €885.8 for three or more conditions), than individuals with no conditions (€580.3). Pharmacy-dispensed medicine expenditure was the largest component of expenditure. People with multimorbidity on average spent more of their equivalised household income on healthcare (7.1% for two conditions, 9.7% for three or more conditions), than people with no conditions (5.0%). A strong positive association was found between number of conditions and OOP healthcare expenditure (p<0.001) and between having private health insurance and OOP healthcare expenditure (p<0.001). A strong negative association was found between eligibility for free primary/hospital care and heavily subsidised medicines and OOP healthcare expenditure (p<0.001).
conclusionsThis study suggests that having multimorbidity in Ireland increases OOP healthcare expenditure, which is problematic for those with more conditions who have lower incomes. This highlights the need for this financial burden to be considered when designing healthcare/funding systems to address multimorbidity, so that access to essential healthcare can be maximised for those with greatest need.
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