Measuring the burden of multimorbidity among Medicare beneficiaries via condition counts and cumulative duration.
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ABSTRACT: Objective
The study's purpose was to describe the cumulative duration of 19 chronic conditions among Medicare fee-for-service (FFS) beneficiaries and examine variation in total expenditures explained by cumulative duration and condition counts.Design, setting, study design, and data extraction
In a retrospective cohort of FFS beneficiaries age ?68, 2015 Medicare enrollment and claims data (N = 20 124 230) were used to identify the presence or absence of 19 diagnosed chronic conditions, and to construct MCC categories (0-1, 2-3, 4-5, 6+) and cumulative duration of each of 19 conditions from the date of first possible occurrence in claims (1/1/1999) to the end of follow-up (date of death or 12/31/2015). Total Medicare expenditures were estimated using linear models adjusted for demographic characteristics.Principal findings
Multimorbidity was common (71.7 percent with 2+ conditions). The mean cumulative duration of all 19 conditions was 23.6 person-years, which varied greatly by age and number of conditions. Condition counts were more predictive of Medicare expenditures than cumulative duration (R-squared for continuous measures = 0.461 vs 0.272; R-squared for quartiles = 0.408 vs 0.266).Conclusions
The cumulative duration of chronic conditions varied widely for Medicare beneficiaries, especially for those with 6+ conditions, but was less predictive of total expenditures than condition counts.
SUBMITTER: Maciejewski ML
PROVIDER: S-EPMC6407342 | biostudies-literature | 2019 Apr
REPOSITORIES: biostudies-literature
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Measuring the burden of multimorbidity among Medicare beneficiaries via condition counts and cumulative duration.
Maciejewski Matthew L ML Hammill Bradley G BG
Health services research 20190220 2
<h4>Objective</h4>The study's purpose was to describe the cumulative duration of 19 chronic conditions among Medicare fee-for-service (FFS) beneficiaries and examine variation in total expenditures explained by cumulative duration and condition counts.<h4>Design, setting, study design, and data extraction</h4>In a retrospective cohort of FFS beneficiaries age ≥68, 2015 Medicare enrollment and claims data (N = 20 124 230) were used to identify the presence or absence of 19 diagnosed chronic condi ...[more]
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