Sanghamitra Pati1, Subhashisa Swain2, Mohammad Akhtar Hussain3, Shridhar Kadam2, Chris Salisbury4. 1. Public Health Foundation of India, Indian Institute of Public Health, Bhubaneswar, Odisha, India sanghamitra.pati@iiphb.org. 2. Public Health Foundation of India, Indian Institute of Public Health, Bhubaneswar, Odisha, India. 3. Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland, Brisbane, Australia. 4. Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
Abstract
PURPOSE: Little information is available on multimorbidity in primary care in India. Because primary care is the first contact of health care for most of the population and important for coordinating chronic care, we wanted to examine the prevalence and correlates of multimorbidity in India and its association with health care utilization. METHODS: Using a structured multimorbidity assessment protocol, we conducted a cross-sectional study, collecting information on 22 self-reported chronic conditions in a representative sample of 1,649 adult primary care patients in Odisha, India. RESULTS: The overall age- and sex-adjusted prevalence of multimorbidity was 28.3% (95% CI, 24.3-28.6) ranging from 5.8% in patients aged 18 to 29 years to 45% in those aged older than 70 years. Older age, female sex, higher education, and high income were associated with significantly higher odds of multimorbidity. After adjusting for age, sex, socioeconomic status (SES), education, and ethnicity, the addition of each chronic condition, as well as consultation at private hospitals, was associated with significant increase in the number of medicines intake per person per day. Increasing age and higher education status significantly raised the number of hospital visits per person per year for patients with multiple chronic conditions. CONCLUSION: Our findings of higher prevalence of multimorbidity and hospitalizations in higher SES individuals contrast with findings in Western countries, where lower SES is associated with a greater morbidity burden.
PURPOSE: Little information is available on multimorbidity in primary care in India. Because primary care is the first contact of health care for most of the population and important for coordinating chronic care, we wanted to examine the prevalence and correlates of multimorbidity in India and its association with health care utilization. METHODS: Using a structured multimorbidity assessment protocol, we conducted a cross-sectional study, collecting information on 22 self-reported chronic conditions in a representative sample of 1,649 adult primary care patients in Odisha, India. RESULTS: The overall age- and sex-adjusted prevalence of multimorbidity was 28.3% (95% CI, 24.3-28.6) ranging from 5.8% in patients aged 18 to 29 years to 45% in those aged older than 70 years. Older age, female sex, higher education, and high income were associated with significantly higher odds of multimorbidity. After adjusting for age, sex, socioeconomic status (SES), education, and ethnicity, the addition of each chronic condition, as well as consultation at private hospitals, was associated with significant increase in the number of medicines intake per person per day. Increasing age and higher education status significantly raised the number of hospital visits per person per year for patients with multiple chronic conditions. CONCLUSION: Our findings of higher prevalence of multimorbidity and hospitalizations in higher SES individuals contrast with findings in Western countries, where lower SES is associated with a greater morbidity burden.
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Authors: Sanghamitra Pati; Subhashisa Swain; Mohammad Akhtar Hussain; Marjan van den Akker; Job Metsemakers; J André Knottnerus; Chris Salisbury Journal: BMJ Open Date: 2015-10-07 Impact factor: 2.692
Authors: Søren T Skou; Frances S Mair; Martin Fortin; Bruce Guthrie; Bruno P Nunes; J Jaime Miranda; Cynthia M Boyd; Sanghamitra Pati; Sally Mtenga; Susan M Smith Journal: Nat Rev Dis Primers Date: 2022-07-14 Impact factor: 65.038
Authors: Sanghamitra Pati; Mohammad Akhtar Hussain; Subhashisa Swain; Chris Salisbury; Job F M Metsemakers; J André Knottnerus; Marjan van den Akker Journal: Biomed Res Int Date: 2016-02-07 Impact factor: 3.411
Authors: Bruno P Nunes; Alexandre D P Chiavegatto Filho; Sanghamitra Pati; Doralice S Cruz Teixeira; Thaynã R Flores; Fabio A Camargo-Figuera; Tiago N Munhoz; Elaine Thumé; Luiz A Facchini; Sandro R Rodrigues Batista Journal: BMJ Open Date: 2017-06-09 Impact factor: 2.692