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Auswirkungen von Multimorbidität auf die Inanspruchnahme medizinischer Versorgungsleistungen und die Versorgungskosten

Effects of multimorbidity on health care utilization and costs

  • Leitthema
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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Multimorbidität ist eine bestimmende Realität in der Versorgung älterer Patienten. Über die spezifischen Effekte von Mehrfacherkrankungen auf die Inanspruchnahme von Versorgungsleistungen und Versorgungskosten ist jedoch nur wenig bekannt. Der vorliegende Beitrag fasst empirische Studien aus der internationalen Literatur zusammen, die den Zusammenhang zwischen Mehrfacherkrankungen und Leistungsinanspruchnahme (ambulante Versorgung, stationäre Versorgung, Pharmakotherapie) und/oder medizinischen Versorgungskosten in der älteren Allgemeinbevölkerung untersucht haben. Obwohl methodische Unterschiede zwischen den Studien ihre Vergleichbarkeit erschwerten – insbesondere aufgrund unterschiedlicher Definitionen und Konzepte von Multimorbidität –, zeigen fast alle einen signifikanten Zusammenhang zwischen der Zahl an vorliegenden chronischen Erkrankungen und der Inanspruchnahme von Versorgungskosten beziehungsweise den Versorgungskosten. In vielen Studien nahmen Inanspruchnahme und/oder Kosten mit jeder zusätzlichen Erkrankung signifikant zu. Im Lichte dieser Ergebnisse werden wichtige Implikationen für die Forschung und Versorgung von Menschen mit Mehrfacherkrankungen vorgestellt und diskutiert.

Abstract

Multiple chronic conditions (multimorbidity) are common among elderly patients; however, little is known about the specific effects of multimorbidity on health care utilization and health care costs. This article reviews empirical studies from the international literature that investigated the relationship between multiple chronic conditions and health care utilization (e.g. ambulatory care, stationary care, pharmacotherapy) and/or health care costs in elderly general populations. Although synthesis of studies was complicated, especially because of ambiguous definitions and measurements of multimorbidity, almost all studies observed a positive association of multimorbidity and utilization and costs. Many studies found that utilization and costs significantly increased with each additional chronic condition. In light of these findings coupled with the fear that current care arrangements may be inappropriate for many multimorbid patients, important implications for research and policy are presented and discussed.

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Danksagung

Diese Arbeit wurde durch das Bundesministerium für Bildung und Forschung gefördert (Förderkennzeichen 01ET1006A und 01ET1004C).

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  1. Institut für Medizinische Soziologie, Sozialmedizin und Gesundheitsökonomie (IMSG), Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    T. Lehnert & H.-H. König

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Correspondence to T. Lehnert.

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Lehnert, T., König, HH. Auswirkungen von Multimorbidität auf die Inanspruchnahme medizinischer Versorgungsleistungen und die Versorgungskosten. Bundesgesundheitsbl. 55, 685–692 (2012). https://doi.org/10.1007/s00103-012-1475-6

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