title: Hospital inpatient costs for adults with multiple chronic conditions.
abstract: This article offers national estimates of the proportions of hospital inpatient cases and cost for adult, nonmaternal patients who have multiple chronic conditions. The authors employ a refined classification of chronic versus acute conditions, collapsed to no more than one condition per distinct category of condition. The number of different chronic conditions provides a simple measure of complexity, differing from measures of severity of illness that pertain to a particular episode of treatment. A multivariate regression finds that the number of chronic conditions is an independent influence on hospital cost per case, controlling for other key determinants. Patients with complex illness (e.g., 3+ or 5+ chronic conditions) have a disproportionately large effect on hospital cost per year. The identification of patients in the hospital with complex illness can help in targeting new covered services in a health plan or in risk adjusting health plan premiums. Current policies and demonstrations for the Medicare program may not be sufficient to address complex illness.
authors.affiliation: Agency for Healthcare Research and Quality, USA.
authors.forename: Bernard
authors.initials: B
authors.lastname: Friedman
authors.forename: H Joanna
authors.initials: HJ
authors.lastname: Jiang
authors.forename: Anne
authors.initials: A
authors.lastname: Elixhauser
authors.forename: Andrew
authors.initials: A
authors.lastname: Segal
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012720:Severity of Illness Index; D014481:United States