Age-Specific Patterns and Dual Economic Burden of Dyadic Chronic Disease Combinations Among Older Inpatients in Inner Mongolia, China
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Abstract
With global aging and rising multimorbidity, China’s large older population strains its healthcare system. This study analyzes age‑specific patterns and dual economic burden (medical and out‑of‑pocket expenses) of common dyadic chronic disease combinations among older inpatients in Inner Mongolia. Using multistage random sampling, we analyzed data from six hospitals (four secondary, two tertiary) in 2022. Patients aged ≥50 years with a diagnosis of a chronic disease were included. The ten most frequent dyadic combinations were extracted from the first five diagnoses. Descriptive statistics, chi-square tests, and one-way ANOVA were used (p < .05). Among 106,202 older inpatients, 73.8% had multimorbidity, and 27.7% presented dyadic combinations. The ten most common combinations (n = 5,190) showed age-clustering (p < .001). Hypertension appeared in six of the top ten patterns, highlighting its pivotal role. “Hypertension + Joint arthrosis” was the costliest, with mean expenses 3.0 and 3.2 times the overall averages for medical and out-of-pocket expenses. Three distinct cost patterns emerged: increasing, declining in the oldest‑old, and stable. High-cost combinations showed financial-risk heterogeneity, especially for cancer patients aged ≥ 80 years. Dyadic combinations are pivotal in multimorbidity progression, and age interacts with disease patterns to shape economic burden. Therefore, tiered, age‑specific interventions are essential to mitigate risk and optimize resource use.
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