Comorbidity and its relationship with health service use and cost in community-living older adults with diabetes: A population-based study in Ontario, Canada

Association between different types of comorbidity and disease burden in patients with diabetes

“…In addition, the duration of hospital stay for patients with a discordant comorbidity was longer, and they were likely to be prescribed more medications than patients with a concordant comorbidity. These findings are in line with those of Fisher et al, who reported that the main drivers of healthcare utilization were non‐diabetes‐related conditions . Discordant comorbidity may have also caused an increased number of unplanned hospitalizations and specialized care utilization, which may have led to patients following treatment plans that compromised the potential to achieve diabetes care goals .…”

“…These findings are in line with those of Fisher et al, who reported that the main drivers of healthcare utilization were non‐diabetes‐related conditions . Discordant comorbidity may have also caused an increased number of unplanned hospitalizations and specialized care utilization, which may have led to patients following treatment plans that compromised the potential to achieve diabetes care goals . As a result of the higher utilization of healthcare services, discordant comorbidity was associated with higher expenditure for office visits, hospitalization, and prescription drug costs for the treatment of patients' conditions compared with concordant comorbidity …”

“…When multiple different comorbidities exist (three or more), the differences between discordant and concordant comorbidity were no longer statistically significant, although overall health care expenditure increased. This pattern may be explained by efficiency in treating multiple conditions; some of the conditions may be managed by the same monitoring or treatment plans, therefore minimal additional costs are necessary . These findings were also consistent for HRQoL outcomes.…”

“…24 Discordant comorbidity may have also caused an increased number of unplanned hospitalizations and specialized care utilization, which may have led to patients following treatment plans that compromised the potential to achieve diabetes care goals. 24 As a result of the higher utilization of healthcare services, discordant comorbidity was associated with higher expenditure for office visits, hospitalization, and prescription drug costs for the treatment of patients' conditions compared with concordant comorbidity. 24 Interestingly, the incremental health expenditure of diabetes patients with discordant comorbidity compared with diabetes patients with concordant comorbidity decreased as the number of comorbidities increased.…”

Community Program Improves Quality of Life and Self‐Management in Older Adults with Diabetes Mellitus and Comorbidity

“…High comorbidity was the norm for our study participants. The high prevalence of comorbidity in older adults is widely recognized, and our related work shows that comorbidity in T2DM clients is an important driver of health service use and costs . Provider training on MCCs (including depression) was provided in this RCT, in response to requests from providers in our pilot study and their recognition that comorbidity is critical in shaping self‐management .…”