Effect of multiple chronic diseases on health care expenditures in childhood

J Prim Care Community Health. 2015 Jan;6(1):2-9. doi: 10.1177/2150131914540916. Epub 2014 Jul 7.


Objectives: To examine multiple chronic conditions and related health care expenditures in children.

Methods: Retrospective cohort study of all dependents of Mayo Clinic employees aged 0-17 on Jan 1, 2004 with continuous health benefits coverage for 4 years (N=14,727). Chronic conditions, health care utilization, and associated expenditures were obtained from medical and pharmacy claims.

Results: The most prevalent chronic conditions were asthma/chronic obstructive pulmonary disease (12%), allergic rhinitis (11%), and behavior problems (9%). The most costly conditions were congenital anomalies, asthma/chronic obstructive pulmonary disease, and behavior problems ($9602, $4335, and $5378 annual cost per child, respectively). Annual health care expenditures increased substantially with the number of chronic conditions, and a small proportion of children with multiple chronic conditions accounted for a large proportion of health care costs. In addition, those with multiple chronic conditions were more likely to persist in the top 10th percentile spender group in year-to-year spending.

Conclusion: Children with multiple chronic conditions accounted for a large proportion of health care expenditures. These children were also likely to persist as high spenders in the 4-year time frame. Further research into effective ways to manage the health care delivery for children with multiple chronic conditions is needed.

Keywords: children; chronic conditions; comorbidities; medical cost; pediatrics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Asthma / economics
  • Child
  • Child Behavior Disorders / economics
  • Child, Preschool
  • Chronic Disease / economics*
  • Cohort Studies
  • Comorbidity*
  • Congenital Abnormalities / economics
  • Delivery of Health Care / economics*
  • Female
  • Health Care Costs*
  • Health Expenditures*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pulmonary Disease, Chronic Obstructive / economics
  • Retrospective Studies
  • Rhinitis, Allergic / economics