Department of Health Sciences, Brunel University London, Uxbridge, Middlesex, United Kingdom.
PLoS One. 2024 May 2;19(5):e0301485. doi: 10.1371/journal.pone.0301485. eCollection 2024.
Multimorbidity, also known as multiple long-term conditions, leads to higher healthcare utilisation, including hospitalisation, readmission, and polypharmacy, as well as a financial burden to families, society, and nations. Despite some progress, the economic burden of multimorbidity remains poorly understood. This paper outlines a protocol for a systematic review that aims to identify and synthesise comprehensive evidence on the economic burden of multimorbidity, considering various definitions and measurements of multimorbidity, including their implications for future cost-of-illness analyses. The review will include studies involving people of all ages with multimorbidity without any restriction on location and setting. Cost-of-illness studies or studies that examined economic burden including model-based studies will be included, and economic evaluation studies will be excluded. Databases including Scopus (that includes PubMed/MEDLINE), Web of Science, CINAHL Plus, PsycINFO, NHS EED (including the HTA database), and the Cost-Effectiveness Analysis Registry, will be searched until March 2024. The risk of bias within included studies will be independently assessed by two authors using appropriate checklists. A narrative synthesis of the main characteristics and results, by definitions and measurements of multimorbidity, will be conducted. The total economic burden of multimorbidity will be reported as mean annual costs per patient and disaggregated based on counts of diseases, disease clusters, and weighted indices. The results of this review will provide valuable insights for researchers into the key cost components and areas that require further investigation in order to improve the rigour of future studies on the economic burden of multimorbidity. Additionally, these findings will broaden our understanding of the economic impact of multimorbidity, inform us about the costs of inaction, and guide decision-making regarding resource allocation and cost-effective interventions. The systematic review's results will be submitted to a peer-reviewed journal, presented at conferences, and shared via an online webinar for discussion.
多种疾病，也被称为多种慢性疾病，会导致更高的医疗保健利用，包括住院、再次入院和多种药物治疗，以及给家庭、社会和国家带来经济负担。尽管取得了一些进展，但多种疾病的经济负担仍未得到充分了解。本文概述了一项系统评价的方案，旨在确定和综合多种疾病的经济负担的综合证据，同时考虑到多种疾病的各种定义和测量方法，包括它们对未来疾病成本分析的影响。该综述将包括所有年龄段患有多种疾病的人群的研究，而不限制地点和环境。将包括疾病成本研究或研究经济负担的研究，包括基于模型的研究，而将排除经济评估研究。将在 Scopus（包括 PubMed/MEDLINE）、Web of Science、CINAHL Plus、PsycINFO、NHS EED（包括 HTA 数据库）和成本效益分析注册中心等数据库中进行搜索，直到 2024 年 3 月。两名作者将使用适当的清单独立评估纳入研究的偏倚风险。将根据多种疾病的定义和测量方法，对主要特征和结果进行叙述性综合。将按患者的平均年度成本报告多种疾病的总经济负担，并根据疾病数量、疾病群和加权指数进行细分。该综述的结果将为研究人员提供有关关键成本组成部分和需要进一步研究的领域的宝贵见解，以提高未来多种疾病经济负担研究的严谨性。此外，这些发现将扩大我们对多种疾病经济影响的理解，使我们了解不作为的成本，并为资源分配和具有成本效益的干预措施的决策提供指导。系统评价的结果将提交给同行评议期刊，在会议上展示，并通过在线网络研讨会分享以供讨论。
