BACKGROUND: In developed countries, primary health care increasingly involves the care of patients with multiple chronic conditions, referred to as multimorbidity. AIM: To describe the epidemiology of multimorbidity and relationships between multimorbidity and primary care consultation rates and continuity of care. DESIGN OF STUDY: Retrospective cohort study. SETTING: Random sample of 99 997 people aged 18 years or over registered with 182 general practices in England contributing data to the General Practice Research Database. METHOD: Multimorbidity was defined using two approaches: people with multiple chronic conditions included in the Quality and Outcomes Framework, and people identified using the Johns Hopkins University Adjusted Clinical Groups (ACG®) Case-Mix System. The determinants of multimorbidity (age, sex, area deprivation) and relationships with consultation rate and continuity of care were examined using regression models. RESULTS: Sixteen per cent of patients had more than one chronic condition included in the Quality and Outcomes Framework, but these people accounted for 32% of all consultations. Using the wider ACG list of conditions, 58% of people had multimorbidity and they accounted for 78% of consultations. Multimorbidity was strongly related to age and deprivation. People with multimorbidity had higher consultation rates and less continuity of care compared with people without multimorbidity. CONCLUSION: Multimorbidity is common in the population and most consultations in primary care involve people with multimorbidity. These people are less likely to receive continuity of care, although they may be more likely to gain from it.
BACKGROUND: In developed countries, primary health care increasingly involves the care of patients with multiple chronic conditions, referred to as multimorbidity. AIM: To describe the epidemiology of multimorbidity and relationships between multimorbidity and primary care consultation rates and continuity of care. DESIGN OF STUDY: Retrospective cohort study. SETTING: Random sample of 99 997 people aged 18 years or over registered with 182 general practices in England contributing data to the General Practice Research Database. METHOD: Multimorbidity was defined using two approaches: people with multiple chronic conditions included in the Quality and Outcomes Framework, and people identified using the Johns Hopkins University Adjusted Clinical Groups (ACG®) Case-Mix System. The determinants of multimorbidity (age, sex, area deprivation) and relationships with consultation rate and continuity of care were examined using regression models. RESULTS: Sixteen per cent of patients had more than one chronic condition included in the Quality and Outcomes Framework, but these people accounted for 32% of all consultations. Using the wider ACG list of conditions, 58% of people had multimorbidity and they accounted for 78% of consultations. Multimorbidity was strongly related to age and deprivation. People with multimorbidity had higher consultation rates and less continuity of care compared with people without multimorbidity. CONCLUSION: Multimorbidity is common in the population and most consultations in primary care involve people with multimorbidity. These people are less likely to receive continuity of care, although they may be more likely to gain from it.
Authors: Jose M Valderas; Barbara Starfield; Bonnie Sibbald; Chris Salisbury; Martin Roland Journal: Ann Fam Med Date: 2009 Jul-Aug Impact factor: 5.166
Authors: Miranda T Schram; Dinnus Frijters; Eloy H van de Lisdonk; Janneke Ploemacher; Anton J M de Craen; Margot W M de Waal; Frank J van Rooij; Jan Heeringa; Albert Hofman; Dorly J H Deeg; Francois G Schellevis Journal: J Clin Epidemiol Date: 2008-06-06 Impact factor: 6.437
Authors: M D Esteban-Vasallo; M F Domínguez-Berjón; J Astray-Mochales; R Gènova-Maleras; A Pérez-Sania; L Sánchez-Perruca; M Aguilera-Guzmán; F J González-Sanz Journal: Fam Pract Date: 2009-10-08 Impact factor: 2.267
Authors: Janko Janković; Sladjana Šiljak; Miloš Erić; Jelena Marinković; Slavenka Janković Journal: Int J Public Health Date: 2017-07-14 Impact factor: 3.380
Authors: H van den Bussche; I Heinen; D Koller; B Wiese; H Hansen; I Schäfer; M Scherer; G Glaeske; G Schön Journal: Z Gerontol Geriatr Date: 2014-07 Impact factor: 1.281