Prevalence and expenditure of health and social care in older persons with multimorbidity in Sweden

Abstract Whilst many multimorbid older adults regard their needs of health and social care to be intertwined, the interdependence of healthcare and social care expenditures has rarely been studied. This study examined healthcare and social care expenditures to estimate the overall costs of multimorbidity in all adults ≥65 years (n = 371,583) living in Region Stockholm, Sweden, in 2019. Register data were used for cross-sectional regression analyses on type of care and related care expenditures comparing individuals with 0-1 chronic conditions with individuals with multimorbidity (≥2 chronic conditions). Associations between care expenditure and income were also analyzed. The findings show that 63% had multimorbidity. Health and social care expenditures increased with age and number of chronic conditions. From around the age of 80 years, social care expenditure exceeded healthcare expenditure. Expenditure on outpatient care and home healthcare increased with age to a greater extent among older adults with multimorbidity compared to those without multimorbidity. Contrary, the difference in emergency care expenditure between multimorbid and non-multimorbid adults was larger at age 65 years than at 95 years. Individuals with multimorbidity incurred on average 12% higher total care expenditure compared to those with 0-1 chronic conditions after adjustment for sociodemographic factors. Individuals in the lowest income group had higher care costs at an earlier age compared to those in the highest income group. Lower income groups also had the highest total care expenditure, suggesting that delaying the onset of multimorbidity in lower socioeconomic groups would have the largest impact on societal costs.