Multimorbidity is associated with higher out-of-pocket spending: a study of older Australians with multiple chronic conditions
Ian McRae A E , Laurann Yen B , Yun-Hee Jeon C , Pushpani M. Herath A and Beverley Essue DA Australian Primary Health Care Research Institute, Ian Potter House, Corner Marcus Clarke and Gordon Streets, The Australian National University, Acton, Canberra, ACT 0200, Australia.
B Menzies Centre for Health Policy, Ian Potter House, Corner Marcus Clarke and Gordon Streets, The Australian National University, Acton, Canberra, ACT 0200, Australia.
C Faculty of Nursing and Midwifery, The University of Sydney, 88 Mallett Street, Camperdown, NSW 2006, Australia.
D The George Institute for Global Health, Level 10, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia.
E Corresponding author. Email: ian.s.mcrae@anu.edu.au
Australian Journal of Primary Health 19(2) 144-149 https://doi.org/10.1071/PY12035
Submitted: 27 March 2012 Accepted: 24 April 2012 Published: 24 May 2012
Abstract
Most older Australians have at least one chronic health condition. The management of chronic disease is associated with potentially severe economic consequences for patients and their households, partially due to the financial burden associated with out-of-pocket costs for medical and health-related care. A questionnaire was mailed to a cross-sectional sample of older Australians in mid-2009, with 4574 responding. Multivariate logistic regression models were developed to investigate the relationships between multimorbidity and out-of-pocket spending on medical and health-related expenses, including the factors associated with severe financial stress among older Australians. We found a positive relationship between number of chronic conditions and out-of-pocket spending on health and that people with multiple chronic conditions tend to be on lower incomes. People with five or more chronic conditions spent on average five times as much on their health as those with no diagnosed chronic conditions and each additional chronic disease added 46% to the likelihood of a person facing a severe financial burden due to health costs.
While health policy may minimise out-of-pocket spending for individual conditions, costs compound rapidly for patients with multiple conditions and this burden falls most heavily on those with the lowest incomes.
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