Healthcare Costs and Health-Related Quality of Life in Older Multimorbid Patients After Hospitalization

Paola Salari; Séverine Henrard; Cian O'Mahony; Paco Welsing; Arjun Bhadhuri; Katharina Tabea Jungo; Thomas Beck; Denis O'Mahony; Stephen Byrne; Anne Spinewine; Wilma Knol; Nicolas Rodondi; Matthias Schwenkglenks

doi:10.1177/11786329231153278

Healthcare Costs and Health-Related Quality of Life in Older Multimorbid Patients After Hospitalization

Health Serv Insights. 2023 Feb 5:16:11786329231153278. doi: 10.1177/11786329231153278. eCollection 2023.

Authors

Paola Salari¹, Séverine Henrard^{2

3}, Cian O'Mahony⁴, Paco Welsing⁵, Arjun Bhadhuri¹, Katharina Tabea Jungo⁶, Thomas Beck⁷, Denis O'Mahony⁸, Stephen Byrne⁴, Anne Spinewine^{2

9}, Wilma Knol¹⁰, Nicolas Rodondi^{6

7}, Matthias Schwenkglenks¹

Affiliations

¹ Institute of Pharmaceutical Medicine (ECPM), University of Basel, Switzerland.
² Louvain Drug Research Institute, Clinical Pharmacy Research Group, UCLouvain, Brussels, Belgium.
³ Institute of Health and Society (IRSS), UCLouvain, Brussels, Belgium.
⁴ Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork University Hospital, Ireland.
⁵ Division of Internal Medicine and Dermatology, University Medical Centre Utrecht, The Netherlands.
⁶ Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
⁷ Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁸ Department of Medicine (Geriatrics), University College Cork, Cork University Hospital, Cork, Ireland.
⁹ CHU UCL Namur, Pharmacy Department, Yvoir, Belgium.
¹⁰ Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.

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 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.

Keywords: HRQoL; elderly; healthcare costs; multimorbidity.