Americans with chronic conditions add substantially to healthcare costs

One-quarter of U.S. adults have multiple chronic conditions (MCC) and most suffer from a combination of diabetes, hypertension, and hyperlipidemia. Not surprisingly, medical expenses are significantly higher for those with MCC, according to a new study.

The Centers for Disease Control and Prevention published the study in late April. It was led by Stephen Machlin and Anita Soni, both with the Agency for Healthcare Research and Quality.

Researchers analyzed the prevalence of MCC and associated medical expenditures for 24,870 adults who were 18 years and older in 2009. Machlin and Soni based their findings on the Medical Expenditure Panel Survey, a federal survey which can produce nationally representative estimates of healthcare expenditures associated with MCC.

Approximately 18% of the patients treated for MCC in 2009 were treated for two to three conditions, and 7% were treated for four or more conditions. Medical expenditures increased substantially with the number of MCCs treated, the researchers found. In 2009, the average expense among people with four or more chronic conditions was almost double that for people with two to three conditions and approximately seven times greater than costs for people treated for no chronic conditions or only one chronic condition.

“Average expenditures for all medical care in 2009 were $8,478 among participants treated for 2 to 3 chronic conditions and $16,257 among those treated for 4 or more chronic conditions,” the authors noted. “When restricted to treatment of chronic conditions only, these averages were $3,693 and $8,935, respectively. In contrast, the average expenditure for all conditions among adults who were not treated for MCC was $2,367.”

“Consequently, reducing the number of chronic conditions among people with such conditions may generate substantial medical care savings,” the authors wrote.

Another finding that could aid in controlling healthcare costs, the researchers noted, is that there were no significant variations in medical expenditures among younger, middle-aged, and older adults with two or more treated conditions. So an emphasis should be placed on treatment of younger patients with several chronic conditions to reduce the prevalence of MCC and lower healthcare costs, they said in the study.

Among patients between 18 and 64 years of age, 33.1% of those with public insurance were treated for two or more chronic conditions, compared with 16.3% of those with private insurance and 8.2% who were uninsured. Among those 65 years of age and older, 65.2% of adults with only Medicare coverage and 67.6% of those with Medicare and supplemental private insurance were treated for MCC, compared with 74.8% of those with Medicare and other public insurance (primarily Medicaid).

The combination of hypertension and hyperlipidemia was the most common pairing for those with MCC, regardless of age or sex. The combination of diabetes with hypertension or hyperlipidemia was also common among all sex and age groups (ranging from 21% for women age 65 and older to 28.3% for men age 65 and older). Among adults treated for at least three chronic conditions, the combination of hypertension, hyperlipidemia, and diabetes was common, regardless of age or sex (ranging from 27.7% for women age 65 and older to 37.5% for men age 45 to 64).