Complex Multimorbidity and Healthcare Expenditure among Adult and Elderly in India

Jayashree Meher , Indian Institute of Technology Bombay
Ashish Singh, Indian Institute of Technology Bombay

Introduction: The global health landscape has shifted dramatically from a focus on communicable diseases to non-communicable diseases (NCDs). This is driven by aging populations, urbanization, and lifestyle changes. As people live longer, they face a higher risk of simultaneous presence of multiple chronic conditions, a phenomenon known as multimorbidity. Further, the co-occurrence of chronic conditions across multiple organ systems, known as complex multimorbidity (CMM). CMM fragments patient care across multiple specialists, leading to uncoordinated treatment, polypharmacy, and a higher risk of adverse outcomes like emergency hospitalizations. Therefore, understanding the impact of multimorbidity especially CMM on healthcare expenditure is crucial to assess the financial burden on the elderly in India. Aim: To investigates CMM's prevalence and its association with out-of-pocket health expenditure (OOPE). Methods: Analyzing Longitudinal Ageing Study in India (LASI) Wave 1 data, we assessed prevalence of CMM via bivariate analysis, risk factors via multinomial logistic regression. Further we used a two-part hurdle model to examine the impact of CMM on out-of-pocket health expenditure. Result: We estimated that 21% of the Indian elderly population has CMM, with states like Kerala and Punjab having highest prevalence rate at 42.6% and 39.2% respectively. Age, education, wealth quintile and tobacco cessation status were found out to be major risk factor of CMM. Further, the result from two-part model revealed that Individuals with complex multimorbidity faced 27.1% higher OOPE compared to those with no morbidity. Conclusion: CMM directly escalates financial burden, highlighting the urgent need for integrated care models to manage complex chronic conditions.

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 Presented in Session P6. Health, Mortality, and Ageing 2