Contact patterns and costs of multiple sclerosis in the Swedish healthcare system—A population‐based quantitative study

Abstract

Background The burden of disease for persons with multiple sclerosis (MS) and society is changing due to new treatments. Knowledge about the total need for care is necessary in relation to changing needs and new service models. Objective The aim of this study was to describe the contact patterns for MS patients, calculate costs in health care, and create meaningful subgroups to analyze contact patterns. Methods All patients diagnosed with MS at Ryhov Hospital were included. All contacts in the region from January 1, 2018, until September 30, 2019, were retrieved from the hospital administrative system. Data about age, sex, contacts, and diagnosis were registered. The cost was calculated using case costing, and costs for prescriptions were calculated from medical files. Results During the 21‐month period, patients (n = 305) had 9628 contacts and 7471 physical visits, with a total cost of $7,766,109. Seventeen percent of the patients accounted for 48% of the visits. The median annual cost was $7386 in the group with 10 or fewer visits, compared to $22,491 in patients with more than 50 visits. Conclusion There are considerable differences in the utilization of care and cost between patients with MS in an unselected population, meaning that the care needs to be better customized to each patient's demands.

Lived experience of persons with multiple sclerosis: A qualitative interview study

“…This suggests a need for more coproduced planning and design with more diverse service options and content to facilitate person‐centered care. Persons living with MS can also have other temporary or chronic conditions with treatments over a shorter or longer period in different parts of the healthcare system (Lind et al., 2022) that need coordination. These findings in the MS population is similar to the Swedish healthcare system as a whole where challenges to anticipate and respond to patients as individuals with particular needs and preferences together with inadequate coordination of care between different healthcare providers have been described (Docteur & Coulter, 2012).…”

“…Within the segments, a random number sample was made where every third person received a letter with written information about the interview study along with an informed consent form. If several F I G U R E 1 Schematic of the different phases of the sampling process for the interview study, based on a former quantitative study that identified four segments of utilization of healthcare services (Lind et al, 2022).…”

“…Coproduction between patients and professionals in quality improvement of healthcare services is suggested to be an opportunity (Lachman et al., 2021 ). In the medical context of MS—with rapid medical development (Tanasescu et al., 2014 ), considerable differences in the utilization of total care and cost (Lind et al., 2022 ), and the increased awareness of the patient's role and knowledge in chronic illness (Gaille, 2019 ; Goulden & Faber, 2020 ; Irvine, 2016 ; Mcintosh & Wright, 2019 )—studies of lived experiences in different contexts and populations over time are important. This study takes place in a Swedish Region with a tradition of quality improvement (Bodenheimer et al., 2007 ; Gäre & Neuhauser, 2007 ; Persson et al., 2021 ; Staines et al., 2015 ).…”

Excess Treatment Costs of Multiple Sclerosis

“…1 People with MS are often diagnosed during their working age, and the diagnosis adversely affects their earning ability, quality of life, and functional capability. 2 Caring for people with MS has enormous financial costs for health care systems, patients, and their caregivers. In the United States, the average excess direct and indirect cost of MS has been estimated at $65,612 per patient per annum (pppa).…”

“…4 In Sweden, the median medical cost of MS is approximately $9,937 pppa. 2 The heterogeneity in cost estimates reflects different countries' medication prices and health system financing models.…”