Post-Hospitalization Costs Highest in Early Months in Older Adults With Multimorbidity

Monthly mean health care costs peaked, and health-related quality of life was highest, 2 months after acute care hospitalization in older adults (OAs) with multiple morbidities and polypharmacy, according to a study published in Health Service Insights. 

“These estimates show that costs increased after the index hospitalization, when the acute problem may still have required medical resource consumption,” wrote corresponding author Paola Salari, PhD, of the University of Basel, Switzerland, and coauthors.  

Researchers investigated health care costs, and time trends of health-related quality of life, over the 12 months after acute care hospitalization for adults aged 70 years or older with 3 or more chronic conditions and taking at least 5 medications regularly. The data used was from the Optimizing Therapy to Prevent Avoidable Hospital Admissions in the Multimorbid Older People trial, conducted in Belgium, Ireland, the Netherlands, and Switzerland, which included 2008 patients. Participants answered questions at baseline and at three follow-up points: 2 months (FUP 1), 6 months (FUP 2), and 12 months (FUP 3) after their hospital stay.  

At the first follow-up point at 2 months, when health care costs crested for patients, the highest cost components were rehabilitation, followed by hospitalization. Rehabilitation costs were less of a factor at later timepoints, according to the study. Age, falls, and comorbidities were linked with higher 12-month costs. 

Health-related quality of life, meanwhile, was lowest at the third follow-up. 

“This trend is consistent with the fact that an acute health problem was addressed at baseline, hence people were relatively healthy at FUP 1 [2 months post-hospitalization]. After FUP 1, their health status started to deteriorate again, and they reported a lower health-related quality of life at FUP 3,” researchers wrote. “This subsequent deterioration was expected given the high age of patients.” 

Being female and housebound were associated with lower health-related quality of life, while moderate consumption of alcohol was associated with higher life quality, the study found. Independence in daily activities was linked with both lower costs and better quality of life. 

“Overall, our results indirectly support the importance of prevention and action before health status deteriorates (eg, promoting safety measures to reduce falls),” researchers wrote.  

Reference: 
Salari P, Henrard S, O'Mahony C, et al. Healthcare costs and health-related quality of life in older multimorbid patients after hospitalization. Health Serv Insights. Published online February 5, 2023. doi:10.1177/11786329231153278