The role of comorbidities in comprehensive healthcare utilization among people with multiple sclerosis

Many people with multiple sclerosis (PwMS) live with comorbid conditions, which may contribute to more complex healthcare needs. While there have been several studies on their associations with increased hospitalizations and emergency visits, there has been limited investigation into other aspects of care (e.g., imaging) or composite indices have been used rather than individual conditions.

To determine If comorbidities in PwMS are associated with utilization of a wider range of healthcare services and which specific comorbid conditions are linked to those services.

Participants (n = 185) were PwMS who completed a series of questionnaires about their comorbidities and healthcare utilization over the prior 12 months as part of a larger study. Regression models were used to evaluate the relationships between healthcare utilization and specific comorbidities, controlling for age, gender, race, education, and annual income.

PwMS with a comorbidity had higher utilization of several services, including more healthcare provider visits (p < 0.001), particularly with primary care (p = .041) and mental health providers (p = .003), unique providers seen (p < 0.001), active medications (p < .001), MRIs (p = .008), X-rays (p = .031), inpatient hospital stays (p = .038), and elective surgeries (p = .035). Several comorbidities, including anxiety, sleep apnea, autoimmune thyroid disease, and irritable bowel syndrome, were most frequently associated with increased service use.

These findings expand upon the previous literature, demonstrating that comorbidities are associated with greater utilization of a wide range of services and the complex needs of PwMS living with multiple chronic conditions.