Sharmaine Sreedhar1, Lauralie Richard2, Tim Stokes3. 1. Medical Student, Dunedin School of Medicine, University of Otago, Dunedin. 2. Research Fellow, Department of General Practice & Rural Health, Dunedin School of Medicine, University of Otago, Dunedin. 3. Elaine Gurr Professor of General Practice, Department of General Practice & Rural Health, Dunedin School of Medicine, University of Otago, Dunedin.
Abstract
AIMS: Multimorbidity is a major issue in primary healthcare. The study aim was to determine the prevalence of multimorbidity and multiple social disadvantage in relation to age, gender, deprivation and ethnicity in a New Zealand high-needs primary healthcare clinic population. METHODS: A cross-sectional study using data manually extracted from electronic medical records was conducted on all patients registered with a Dunedin free 'third sector' primary healthcare clinic. The data were analysed in terms of the number and type of morbidities, and prevalence of multimorbidity in relation to age, sex and multiple social disadvantage. RESULTS: Most patients had multimorbidity (76.5%, 95% CI 72.0-85.5%) and half (49.9%, 95% CI 44.8-54.9%) had long-term physical and mental health comorbidities. The prevalence of multimorbidity in patients in all ethnic groups increased with age and was high across all ethnic groups and deprivation quintiles. Seven of the 10 most prevalent long-term conditions were mental health conditions. A majority of patients (54.7%, 95% CI 49.4-59.8%) had at least one multiple social disadvantage domain recorded. CONCLUSIONS: The high prevalence of multimorbidity in a high-needs population served by a 'third sector' clinic raises important issues relating to equity in the New Zealand health system.
AIMS: Multimorbidity is a major issue in primary healthcare. The study aim was to determine the prevalence of multimorbidity and multiple social disadvantage in relation to age, gender, deprivation and ethnicity in a New Zealand high-needs primary healthcare clinic population. METHODS: A cross-sectional study using data manually extracted from electronic medical records was conducted on all patients registered with a Dunedin free 'third sector' primary healthcare clinic. The data were analysed in terms of the number and type of morbidities, and prevalence of multimorbidity in relation to age, sex and multiple social disadvantage. RESULTS: Most patients had multimorbidity (76.5%, 95% CI 72.0-85.5%) and half (49.9%, 95% CI 44.8-54.9%) had long-term physical and mental health comorbidities. The prevalence of multimorbidity in patients in all ethnic groups increased with age and was high across all ethnic groups and deprivation quintiles. Seven of the 10 most prevalent long-term conditions were mental health conditions. A majority of patients (54.7%, 95% CI 49.4-59.8%) had at least one multiple social disadvantage domain recorded. CONCLUSIONS: The high prevalence of multimorbidity in a high-needs population served by a 'third sector' clinic raises important issues relating to equity in the New Zealand health system.