International comparison of health spending and utilization among people with complex multimorbidity.

Figueroa, JF; Papanicolas, I; Riley, K; Abiona, O; Arvin, M; Atsma, F; Bernal-Delgado, E; Bowden, N; Blankart, CR; Deeny, S; Estupiñán-Romero, F; Gauld, R; Haywood, P; Janlov, N; Knight, H; Lorenzoni, L; Marino, A; Or, Z; Penneau, A; Shatrov, K; van de Galien, O; van Gool, K; Wodchis, W; Jha, AK

International comparison of health spending and utilization among people with complex multimorbidity.

Figueroa, JF Papanicolas, I Riley, K Abiona, O

Arvin, M Atsma, F Bernal-Delgado, E Bowden, N Blankart, CR Deeny, S Estupiñán-Romero, F Gauld, R Haywood, P

Janlov, N Knight, H Lorenzoni, L Marino, A Or, Z Penneau, A Shatrov, K van de Galien, O van Gool, K Wodchis, W Jha, AK

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Health Serv Res, 2021, 56 Suppl 3, (S3), pp. 1317-1334
Issue Date:: 2021-12

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Field	Value	Language
dc.contributor.author	Figueroa, JF
dc.contributor.author	Papanicolas, I
dc.contributor.author	Riley, K
dc.contributor.author	Abiona, O https://orcid.org/0000-0002-1696-4475
dc.contributor.author	Arvin, M
dc.contributor.author	Atsma, F
dc.contributor.author	Bernal-Delgado, E
dc.contributor.author	Bowden, N
dc.contributor.author	Blankart, CR
dc.contributor.author	Deeny, S
dc.contributor.author	Estupiñán-Romero, F
dc.contributor.author	Gauld, R
dc.contributor.author	Haywood, P https://orcid.org/0000-0001-5031-8648
dc.contributor.author	Janlov, N
dc.contributor.author	Knight, H
dc.contributor.author	Lorenzoni, L
dc.contributor.author	Marino, A
dc.contributor.author	Or, Z
dc.contributor.author	Penneau, A
dc.contributor.author	Shatrov, K
dc.contributor.author	van de Galien, O
dc.contributor.author	van Gool, K
dc.contributor.author	Wodchis, W
dc.contributor.author	Jha, AK
dc.date.accessioned	2022-01-17T21:42:16Z
dc.date.available	2021-06-27
dc.date.available	2022-01-17T21:42:16Z
dc.date.issued	2021-12
dc.identifier.citation	Health Serv Res, 2021, 56 Suppl 3, (S3), pp. 1317-1334
dc.identifier.issn	0017-9124
dc.identifier.issn	1475-6773
dc.identifier.uri	http://hdl.handle.net/10453/153220
dc.description.abstract	OBJECTIVE: The objective of this study was to explore cross-country differences in spending and utilization across different domains of care for a multimorbid persona with heart failure and diabetes. DATA SOURCES: We used individual-level administrative claims or registry data from inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries: Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States (US). DATA COLLECTION/EXTRACTION METHODS: Data collected by ICCONIC partners. STUDY DESIGN: We retrospectively analyzed age-sex standardized utilization and spending of an older person (65-90 years) hospitalized with a heart failure exacerbation and a secondary diagnosis of diabetes across five domains of care: hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, and outpatient drugs. PRINCIPAL FINDINGS: Sample sizes ranged from n = 1270 in Spain to n = 21,803 in the United States. Mean age (standard deviation [SD]) ranged from 76.2 (5.6) in the Netherlands to 80.3 (6.8) in Sweden. We observed substantial variation in spending and utilization across care settings. On average, England spent $10,956 per person in hospital care while the United States spent $30,877. The United States had a shorter length of stay over the year (18.9 days) compared to France (32.9) and Germany (33.4). The United States spent more days in facility-based rehabilitative care than other countries. Australia spent $421 per person in primary care, while Spain (Aragon) spent $1557. The United States and Canada had proportionately more visits to specialist providers than primary care providers. Across almost all sectors, the United States spent more than other countries, suggesting higher prices per unit. CONCLUSION: Across 11 countries, there is substantial variation in health care spending and utilization for a complex multimorbid persona with heart failure and diabetes. Drivers of spending vary across countries, with the United States being the most expensive country due to high prices and higher use of facility-based rehabilitative care.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation	The Health Foundation
dc.relation	Harvard University
dc.relation.ispartof	Health Serv Res
dc.relation.isbasedon	10.1111/1475-6773.13708
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services, 1605 Policy and Administration
dc.subject.classification	Health Policy & Services
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Australia
dc.subject.mesh	Developed Countries
dc.subject.mesh	Diabetes Mellitus
dc.subject.mesh	Europe
dc.subject.mesh	Health Care Costs
dc.subject.mesh	Heart Failure
dc.subject.mesh	Humans
dc.subject.mesh	Multimorbidity
dc.subject.mesh	North America
dc.subject.mesh	Patient Acceptance of Health Care
dc.subject.mesh	Registries
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Severity of Illness Index
dc.title	International comparison of health spending and utilization among people with complex multimorbidity.
dc.type	Journal Article
utslib.citation.volume	56 Suppl 3
utslib.location.activity	United States
utslib.for	1117 Public Health and Health Services
utslib.for	1605 Policy and Administration
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access	*
dc.date.updated	2022-01-17T21:42:14Z
pubs.issue	S3
pubs.publication-status	Published
pubs.volume	56 Suppl 3
utslib.citation.issue	S3

Abstract:

OBJECTIVE: The objective of this study was to explore cross-country differences in spending and utilization across different domains of care for a multimorbid persona with heart failure and diabetes. DATA SOURCES: We used individual-level administrative claims or registry data from inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries: Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States (US). DATA COLLECTION/EXTRACTION METHODS: Data collected by ICCONIC partners. STUDY DESIGN: We retrospectively analyzed age-sex standardized utilization and spending of an older person (65-90 years) hospitalized with a heart failure exacerbation and a secondary diagnosis of diabetes across five domains of care: hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, and outpatient drugs. PRINCIPAL FINDINGS: Sample sizes ranged from n = 1270 in Spain to n = 21,803 in the United States. Mean age (standard deviation [SD]) ranged from 76.2 (5.6) in the Netherlands to 80.3 (6.8) in Sweden. We observed substantial variation in spending and utilization across care settings. On average, England spent $10,956 per person in hospital care while the United States spent $30,877. The United States had a shorter length of stay over the year (18.9 days) compared to France (32.9) and Germany (33.4). The United States spent more days in facility-based rehabilitative care than other countries. Australia spent $421 per person in primary care, while Spain (Aragon) spent $1557. The United States and Canada had proportionately more visits to specialist providers than primary care providers. Across almost all sectors, the United States spent more than other countries, suggesting higher prices per unit. CONCLUSION: Across 11 countries, there is substantial variation in health care spending and utilization for a complex multimorbid persona with heart failure and diabetes. Drivers of spending vary across countries, with the United States being the most expensive country due to high prices and higher use of facility-based rehabilitative care.

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http://hdl.handle.net/10453/153220