reports

The additional cost of chronic disease in Manitoba

Winnipeg, MB, Canada: Manitoba Centre for Health Policy.

Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada

Many Manitobans have a chronic disease—indeed in some age groups most Manitobans have a chronic disease. This places a burden on them and on the healthcare system. Manitoba Health asked the Manitoba Centre for Health Policy to look at the cost of chronic disease and describe how much more it costs to provide healthcare to people who have one of fi ve chronic conditions in comparison with others who do not. In this report, we compare the costs of healthcare for people with arthritis, asthma and chronic obstructive pulmonary disease (COPD), coronary heart disease, diabetes, and stroke with those who do not have the condition. Not surprisingly we fi nd that the costs of healthcare are greater for those with a chronic condition, but we are now able to quantify these additional costs and compare them across diseases and areas. If we can fi nd ways to prevent chronic diseases (or at least reduce their prevalence), we can determine the impact of this on the cost of healthcare.
In this report, we have not limited our cost estimates to the cost of the chronic disease alone; for example, we do not report only the cost for diabetes drugs for people with diabetes or the cost of physician visits that are reported by the doctor as being directly related to a stroke. Rather we look at individuals who have one of these fi ve conditions and compare all of their healthcare costs to those who do not have the condition. And we do this in two ways. First, we compare them to an age and sex matched cohort of other Manitobans—for example all 50 year old men with diabetes are matched with 50 year old men without diabetes—and we look at the diff erences between the group that has the condition and the age–sex matched group that does not have it. This provides us with a direct comparison of people with and without the condition. We also compare the cost of healthcare for all Manitobans who have at least one of the conditions with all Manitobans who do not have the condition. We use statistical methods to control for age, sex, and other conditions (i.e., comorbidity) that each individual has to make sure the diff erences between the two groups are likely associated with the presence or absence of the chronic disease of interest. In addition to looking at total costs we itemize costs for physician services, inpatient and day surgery hospital care, prescription drugs, home care, and personal care home (nursing home) residence.
Using established algorithms and the data repository housed at the Manitoba Centre for Health Policy, we found 119,193 Manitobans over the age of 19 who are being treated for asthma or COPD. On average, these individuals received $8,500 in health services within a two–year period.1 This compares with $4,900 for a matched cohort of those who do not have asthma or COPD. Similarly, there were 48,000 people with diabetes and their average two year healthcare costs were just under $14,000 in comparison with a little under $6,400 for a matched cohort of people who do not have diabetes.