{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T13:30:06Z","timestamp":1786714206753,"version":"build-2736575974"},"reference-count":43,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish Research Council for Health, Working Life, and Welfare","award":["2021-01830"],"award-info":[{"award-number":["2021-01830"]}]},{"name":"Swedish Research Council for Health, Working Life, and Welfare","award":["2022-00901"],"award-info":[{"award-number":["2022-00901"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,1]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to assess socioeconomic differentials in the prevalence of multimorbidity among adults \u226565 years, health and social care expenditure and its effect on total care expenditure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based cross-sectional register study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Region Stockholm, Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Persons \u226565 years (N=371\u2009583), in Region Stockholm in 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome<\/jats:title>\n                    <jats:p>Total health and social care expenditure per individual in 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Secondary outcome<\/jats:title>\n                    <jats:p>Prevalence and sociodemographic patterns of multimorbidity, differences in care expenditure across socioeconomic groups and the composition of services used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Multimorbidity prevalence was 62.6% among adults aged \u226565 years (N=371\u2009583), increasing with age and occurring earlier in lower income groups. Average total care expenditure increased from 34\u2009346 Swedish Kronor (SEK) among individuals with no chronic conditions and 55\u2009606 SEK among those with one condition to 143\u2009063 SEK among those with \u22654 chronic conditions. Social care expenditure exceeded healthcare expenditure from age 80 years onwards. In adjusted gamma regression models, multimorbidity was associated with 11.6% higher total care expenditure (cost ratio (CR) 1.116, CI 1.114 to 1.118). Compared with the highest income group, expenditure was also higher among those in the lowest (CR: 1.038, CI 1.036 to 1.040) and second-lowest income groups (CR: 1.011, CI 1.009 to 1.013).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multimorbidity is increasingly prevalent in older ages and is associated with higher health and social care expenditure. This poses a challenge to organising and financing healthcare, and critically, social care services, in the future. More resources should be allocated to health promotion and prevention to delay onset, targeting lower socioeconomic groups. Alternative approaches to organising care that balance quality, equity and cost-effectiveness should be explored.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106179","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:40:32Z","timestamp":1786711232000},"page":"e106179","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Socioeconomic differentials in multimorbidity prevalence, health and social care expenditure among persons 65 years and older in region Stockholm, Sweden: a population-based study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-1239","authenticated-orcid":false,"given":"Megan","family":"Doheny","sequence":"first","affiliation":[{"name":"Aging Research Center, Karolinska Institutet, Stockholm, Stockholm County, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Burstr\u00f6m","sequence":"additional","affiliation":[{"name":"Global Public Health, Karolinska Institutet, Stockholm, Sweden"},{"name":"Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne","family":"Agerholm","sequence":"additional","affiliation":[{"name":"Aging Research Center, Karolinska Institutet, Stockholm, Stockholm County, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2358-6046","authenticated-orcid":false,"given":"Ann","family":"Liljas","sequence":"additional","affiliation":[{"name":"Global Public Health, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2026081405402224000_16.8.e106179.1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.201473"},{"key":"2026081405402224000_16.8.e106179.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cky098"},{"key":"2026081405402224000_16.8.e106179.3","doi-asserted-by":"crossref","first-page":"101860","DOI":"10.1016\/j.eclinm.2023.101860","article-title":"Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis","volume":"57","author":"Chowdhury","year":"2023","journal-title":"eClinicalMedicine"},{"key":"2026081405402224000_16.8.e106179.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(00)00363-2"},{"key":"2026081405402224000_16.8.e106179.5","doi-asserted-by":"crossref","DOI":"10.1038\/s41467-020-16780-x","article-title":"Twelve-year clinical trajectories of multimorbidity in a population of older adults","volume":"11","author":"Vetrano","year":"2020","journal-title":"Nat Commun"},{"key":"2026081405402224000_16.8.e106179.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0102149","article-title":"Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies","volume":"9","author":"Violan","year":"2014","journal-title":"PLoS One"},{"key":"2026081405402224000_16.8.e106179.7","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S97248"},{"key":"2026081405402224000_16.8.e106179.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60240-2"},{"key":"2026081405402224000_16.8.e106179.9","doi-asserted-by":"crossref","unstructured":"Wikstr\u00f6m K , Linna M , Reissell E , et al . 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