ArticleHealth research policy and systems2024
Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study).
Article in Health research policy and systems, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed, 6 citations in OpenAlex.
- The economic cost of outpatient primary care of adults with multimorbidity (HIV, diabetes, and hypertension) in rural South Africa.Health policy and planning · 2026Article
- Post-acute healthcare expenditure following COVID-19 hospitalization and associated social inequalities in Belgium: a matched cohort study.BMC health services research · 2026Article
- Multimorbidity and the indirect cost of productivity loss from health-related work absenteeism in Belgium.European journal of public health · 2025Observational
- Association of socioeconomic and lifestyle factors with the prevalence of chronic noncommunicable disease multimorbidity in rural Southwest China: a structural equation modeling approach.Archives of public health = Archives belges de sante publique · 2025Article
- Impact of multimorbidity on healthcare costs in patients with type 2 diabetes in China: a longitudinal analysis of health insurance claims data.Archives of public health = Archives belges de sante publique · 2025Article
- Top comorbidities in osteoporotic fracture patients in a northeast population in China.BMC public health · 2025Article
- Multimorbidity combinations among older adults in Singapore: A cross-sectional study using polyclinic data.Journal of multimorbidity and comorbidityArticle
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundThe complex management of health needs in multimorbid patients, alongside limited cost data, presents challenges in developing cost-effective patient-care pathways. We estimated the costs of managing 171 dyads and 969 triads in Belgium, taking into account the influence of morbidity interactions on costs.
methodsWe followed a retrospective longitudinal study design, using the linked Belgian Health Interview Survey 2018 and the administrative claim database 2017-2020 hosted by the Intermutualistic Agency. We included people aged 15 and older, who had complete profiles (N = 9753). Applying a system costing perspective, the average annual direct cost per person per dyad/triad was presented in 2022 Euro and comprised mainly direct medical costs. We developed mixed models to analyse the impact of single chronic conditions, dyads and triads on healthcare costs, considering two-/three-way interactions within dyads/triads, key cost determinants and clustering at the household level.
resultsPeople with multimorbidity constituted nearly half of the study population and their total healthcare cost constituted around three quarters of the healthcare cost of the study population. The most common dyad, arthropathies + dorsopathies, with a 14% prevalence rate, accounted for 11% of the total national health expenditure. The most frequent triad, arthropathies + dorsopathies + hypertension, with a 5% prevalence rate, contributed 5%. The average annual direct costs per person with dyad and triad were €3515 (95% CI 3093-3937) and €4592 (95% CI 3920-5264), respectively. Dyads and triads associated with cancer, diabetes, chronic fatigue, and genitourinary problems incurred the highest costs. In most cases, the cost associated with multimorbidity was lower or not substantially different from the combined cost of the same conditions observed in separate patients.
conclusionPrevalent morbidity combinations, rather than high-cost ones, made a greater contribution to total national health expenditure. Our study contributes to the sparse evidence on this topic globally and in Europe, with the aim of improving cost-effective care for patients with diverse needs.
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