TITLE

Implications of comorbidity for primary care costs in the UK: a retrospective observational study

AUTHOR(S)
Brilleman, Samuel L.; Purdy, Sarah; Salisbury, Chris; Windmeijer, Frank; Gravelle, Hugh; Hollinghurst, Sandra
PUB. DATE
April 2013
SOURCE
British Journal of General Practice;Apr2013, Vol. 63 Issue 609, pe274
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Comorbidity is increasingly common in primary care. The cost implications for patient care and budgetary management are unclear. Aim: To investigate whether caring for patients with specific disease combinations increases or decreases primary care costs compared with treating separate patients with one condition each. Design: Retrospective observational study using data on 86 100 patients in the General Practice Research Database. Method: Annual primary care cost was estimated for each patient including consultations, medication, and investigations. Patients with comorbidity were defined as those with a current diagnosis of more than one chronic condition in the Quality and Outcomes Framework. Multiple regression modelling was used to identify, for three age groups, disease combinations that increase (cost-increasing) or decrease (cost-limiting) cost compared with treating each condition separately. Results: Twenty per cent of patients had at least two chronic conditions. All conditions were found to be both cost-increasing and cost-limiting when co-occurring with other conditions except dementia, which is only cost-limiting. Depression is the most important costincreasing condition when co-occurring with a range of conditions. Hypertension is costlimiting, particularly when co-occurring with other cardiovascular conditions. Conclusion: Three categories of comorbidity emerge, those that are: cost-increasing, mainly due to a combination of depression with physical comorbidity; cost-limiting because treatment for the conditions overlap; and cost-limiting for no apparent reason but possibly because of inadequate care. These results can contribute to efficient and effective management of chronic conditions in primary care.
ACCESSION #
86439538

 

Related Articles

  • Independent Nurse: NPs no more cost-effective than GPs. Sands, Judy // GP: General Practitioner;8/12/2005, p73 

    The article cites a study that showed that employing a nurse practitioner (NP) in primary care is likely to cost much the same as employing a salaried general practitioner. In the study, researchers found that the mean cost of a NP consultation was about pounds 9.46 while a salaried GP's was...

  • Primary Care Physicians and Specialists as Personal Physicians. Franks, Peter; Fiscella, Kevin // Journal of Family Practice;Aug1998, Vol. 47 Issue 2, p105 

    BACKGROUND. The advent of managed care has resulted in considerable debate regarding the relative effects of specialist and primary care on patient outcomes and costs. Studies on these subjects have been limited to a disease-focused orientation rather than a patient-focused orientation inherent...

  • A quiet revolution in primary care. Kennedy, Barbara // Medeconomics;Oct2004, Vol. 25 Issue 10, p16 

    This article focuses on the revolution in primary care. PCOs and general practice are facing a quiet revolution. The government wants to lever private and commercial sector contracts into primary and community services. Meanwhile, the range of contracts available within the primary care sector...

  • MedEconomics: Practice Earnings - Maximising GP minor surgery income. Phipps // GP: General Practitioner;2/29/2012, p30 

    The article reports that there are several ways in which a medical practise can generate income from a minor surgery service. When the current bill from secondary care is studied, reallocating money from funding these procedures in hospitals to general practice is often an easy step with...

  • Opinion: Leader - New batteries needed to calculate true cost.  // GP: General Practitioner;5/31/2004, p28 

    The article focuses on general practitioners' contract. When the figures translate to pounds 2 billion and pounds 1 billion and cover the whole national health services' primary care budget might expect more drastic action. Some primary care experts are predicting that the new contract is...

  • Business as usual for general practice. Foley, Peter // New Zealand Doctor;5/19/2004, p40 

    Comments on the public misconceptions about the realities of operating a small general practice in New Zealand. Impact of the Holidays Act on the staff cost for general practice; Importance of general practice payment model to the development of primary health care strategy; Concerns about the...

  • Opinion: NHS forced to value consultants. Lancelot, Chris // GP: General Practitioner;5/24/2004, p38 

    From time to time GP's need to look at the pressures and upheavals in areas of medicine outside primary care. Hospital consultants in particular are having their lives turned upside down through the restructuring of their own new contract and the European working time directive. Because junior...

  • Independent Nurse: Opinion - Don't compare NPs and GPs on cost alone. Bower, Emma // GP: General Practitioner;8/12/2005, p80 

    The article focuses on primary care costs related to employment of nurse practitioner (NP) and salaried general practitioner (GP) in primary care. According to a study, employing NP in primary care costs much the same as employing a salaried GP. The time spent by a GP contributing to an NP...

  • What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care. Philips, Hilde; Remmen, Roy; Van Royen, Paul; Teblick, Marc; Geudens, Leo; Bronckaers, Marc; Meeuwis, Herman // BMC Health Services Research;2010, Vol. 10, p222 

    Background: Out-of-hours care in the primary care setting is rapidly changing and evolving towards general practitioner 'cooperatives' (GPC). GPCs already exist in the Netherlands, the United Kingdom and Scandinavia, all countries with strong general practice, including gatekeepers' role. This...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics