Hospital inpatient costs for adults with multiple chronic conditions

Med Care Res Rev. 2006 Jun;63(3):327-46. doi: 10.1177/1077558706287042.


This article offers national estimates of the proportions of hospital inpatient cases and cost for adult, nonmaternal patients who have multiple chronic conditions. The authors employ a refined classification of chronic versus acute conditions, collapsed to no more than one condition per distinct category of condition. The number of different chronic conditions provides a simple measure of complexity, differing from measures of severity of illness that pertain to a particular episode of treatment. A multivariate regression finds that the number of chronic conditions is an independent influence on hospital cost per case, controlling for other key determinants. Patients with complex illness (e.g., 3+ or 5+ chronic conditions) have a disproportionately large effect on hospital cost per year. The identification of patients in the hospital with complex illness can help in targeting new covered services in a health plan or in risk adjusting health plan premiums. Current policies and demonstrations for the Medicare program may not be sufficient to address complex illness.

MeSH terms

  • Aged
  • Chronic Disease / economics*
  • Chronic Disease / epidemiology
  • Comorbidity*
  • Cost of Illness
  • Female
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Inpatients / statistics & numerical data*
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Regression Analysis
  • Severity of Illness Index
  • United States