Healthcare Costs and Health-Related Quality of Life in Older Multimorbid Patients After Hospitalization
Salari, Paola; Henrard, Séverine; O’Mahony, Cian; Welsing, Paco; Bhadhuri, Arjun; Jungo, Katharina Tabea; Beck, Thomas; O’Mahony, Denis; Byrne, Stephen; Spinewine, Anne; Knol, Wilma; Rodondi, Nicolas; Schwenkglenks, Matthias
(2023) Health services insights, volume 16
(Article)
Abstract
Objectives: We identified factors associated with healthcare costs and health-related quality of life (HRQoL) of multimorbid older adults with polypharmacy. Methods: Using data from the OPERAM (OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid older people) trial, we described the magnitude and composition of healthcare costs, and time
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trends of HRQoL, during 1-year after an acute-care hospitalization. We performed a cluster analysis to identify groups with different cost and HRQoL trends. Using multilevel models, we also identified factors associated with costs and HRQoL. Results: Two months after hospitalization monthly mean costs peaked (CHF 7′124) and HRQoL was highest (0.67). They both decreased thereafter. Age, falls, and comorbidities were associated with higher 1-year costs. Being female and housebound were negatively associated with HRQoL, while moderate alcohol consumption had a positive association. Being independent in daily activities was associated with lower costs and higher HRQoL. Conclusion: Although only some identified potential influences on costs and HRQoL are modifiable, our observations support the importance of prevention before health deterioration in older people with multimorbid illness and associated polypharmacy.
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Keywords: elderly, healthcare costs, HRQoL, multimorbidity, Health Policy, Public Health, Environmental and Occupational Health
ISSN: 1178-6329
Publisher: SAGE Publications Ltd
Note: Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is part of the project “OPERAM: OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly” supported by the European Union’s Horizon 2020 research and innovation program under the grant agreement No 634238, and by the Swiss State Secretariat for Education, Research and Innovation (SERI) under contract number 15.0137. The opinions expressed and arguments employed herein are those of the authors and do not necessarily reflect the official views of the European Commission and the Swiss government. This project was also partially funded by the Swiss National Scientific Foundation (SNSF 320030_188549 and 325130_204361/1.). The funder of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. Funding Information: We would like to thank Marie Roumet for her support in the data cleaning process and her valuable comments, Flavia Lazzeri for her availability in providing and interpreting Spitex data, the Insel Data Science Centre for providing hospitalizations data, and Helsana for providing unit cost data. The EQ-5D instrument is used by permission of the EuroQol Group. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is part of the project “OPERAM: OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly” supported by the European Union’s Horizon 2020 research and innovation program under the grant agreement No 634238, and by the Swiss State Secretariat for Education, Research and Innovation (SERI) under contract number 15.0137. The opinions expressed and arguments employed herein are those of the authors and do not necessarily reflect the official views of the European Commission and the Swiss government. This project was also partially funded by the Swiss National Scientific Foundation (SNSF 320030_188549 and 325130_204361/1.). The funder of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. Publisher Copyright: © The Author(s) 2023.
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