title: Review: health care utilization and costs of elderly persons with multiple chronic conditions.
abstract: This systematic literature review identified and summarized 35 studies that investigated the relationship between multiple chronic conditions (MCCs) and health care utilization outcomes (i.e. physician use, hospital use, medication use) and health care cost outcomes (medication costs, out-of-pocket costs, total health care costs) for elderly general populations. Although synthesis of studies was complicated because of ambiguous definitions and measurements of MCCs, and because of the multitude of outcomes investigated, almost all studies observed a positive association of MCCs and use/costs, many of which found that use/costs significantly increased with each additional condition. Several studies indicate a curvilinear, near exponential relationship between MCCs and costs. The rising prevalence, substantial costs, and the fear that current care arrangements may be inappropriate for many patients with MCCs, bring about a multitude of implications for research and policy, of which the most important are presented and discussed.
authors.affiliation: University Medical Center Hamburg-Eppendorf, Germany. t.lehnert@uke.uni-hamburg.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehnert
authors.forename: Dirk
authors.initials: D
authors.lastname: Heider
authors.forename: Hanna
authors.initials: H
authors.lastname: Leicht
authors.forename: Sven
authors.initials: S
authors.lastname: Heinrich
authors.forename: Sandro
authors.initials: S
authors.lastname: Corrieri
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Steffi
authors.initials: S
authors.lastname: Riedel-Heller
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000191:economics*; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D014481:United States