• Shu Yun Tan, Kaiwei Jeremy Lew, Ying Xie, Poay Sian Sabrina Lee, Hui Li Koh, Yew Yoong Ding, and Eng Sing Lee.
• Clinical Research Unit, National Healthcare Group Polyclinics, Singapore.
• Ann Acad Med Singap. 2021 Nov 1; 50 (11): 809-817.

IntroductionThe rising prevalence of multiple chronic diseases is an important public health issue as it is associated with increased healthcare utilisation. This paper aimed to explore the annual per capita healthcare cost in primary care for patients with multiple chronic diseases (multimorbidity).MethodsThis was a retrospective cohort study conducted in a cluster of public primary care clinics in Singapore. De-identified data from electronic medical records were extracted from July 2015 to June 2017. Only patients with at least 1 chronic disease were included in the study. Basic demographic data and healthcare cost were extracted. A list of 20 chronic diseases was considered for multimorbidity.ResultsThere were 254,377 patients in our study population, of whom 52.8% were female. The prevalence of multimorbidity was 62.4%. The median annual healthcare cost per capita for patients with multimorbidity was about twice the amount compared to those without multimorbidity (SGD683 versus SGD344). The greatest percentage increment in cost was when the number of chronic diseases increased from 2 to 3 (43.0%).ConclusionMultimorbidity is associated with higher healthcare cost in primary care. Since evidence for the optimal management of multimorbidity is still elusive, prevention or delay in the onset of multimorbidity in the general population is paramount.

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