Full
Outline
To assess the economic burden of multimorbidity and complex multimorbidity, focusing on cost variations across medical insurance system, synergistic cost effects of multimorbidity clusters, and expenditure patterns among older versus non-older adults, thereby providing evidence to optimize disease management, health resource allocation, and targeted interventions for high-risk populations.
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, CNKI, WanFang Data, SinoMed, PubMed, Embase, Web of Science,Scopus, and Cochrane Library were systematically searched for studies on the economic burden of multimorbidity until July 2024. Two reviewers independently screened studies and extracted data. Meta-analysis was performed using Review Manager 5.4 and Stata 18.0.
A total of 27 studies with 13 266 248 participants were included. Patients with multimorbidity had significantly higher annual per capita costs across all categories compared to those with a single condition. Healthcare costs (Total: SMD=0.34, 95% CI: 0.08-0.60; Out-of-pocket: SMD=0.36, 95% CI: 0.11-0.60), hospitalization costs (Total: SMD=0.36, 95% CI: 0.20-0.51; Out-of-pocket SMD=0.20, 95% CI: 0.02-0.39), and outpatient costs (Total: SMD=0.34, 95% CI:-0.02-0.70; Out-of-pocket: SMD=0.20, 95% CI: 0.04-0.36). Costs were also higher for ≥4 conditions than for ≥2.Geographically, total costs were higher in the US and the Eurozone than in mainland China and Singapore. The cost increase effect was highest in the US (SMD=0.38, 95% CI: 0.36-0.40), followed by Eurozone (SMD=0.26, 95% CI: 0.21-0.30) and China (SMD=0.26, 95% CI: 0.12-0.40), with significant subgroup differences (P<0.001). Costs varied by multimorbidity patterns (e.g., higher for diabetes/hypertension), severity (positively correlated with cumulative illness scores and CCI), and age (higher in adults ≥65 years).
Multimorbidity imposes a significant economic burden with regional and group variations. Optimized disease management, improved health insurance coverage, and targeted health policies to reduce the burden are urgently needed. Future studies should focus on economic impacts of specific multimorbidity patterns to develop precise interventions.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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