The importance of multi-morbidity in explaining utilisation and costs across health and social care settings

Abstract: South Somerset’s Symphony project aims to foster greater collaboration between primary, community, mental health, acute and social care, particularly for people with complex conditions. To support this aim, we examine patterns of health and social care utilisation and costs for the local population so as to identify which groups of people would most benefit from better integrated care. This involves assessing: the frequency of occurrence of underlying conditions; multi-morbidity profiles; the costs of care; and utilisation of services across diverse settings. We employ two-part regression models to explain variability in individual health and social costs, in total and in each setting. The analyses are used to identify those for whom integrated arrangements should be targeted and to estimate the size of integrated health and social care budgets for people with particular co-morbidity profiles.