Healthcare use in patients with multimorbidity

• Published in: European journal of public health 2020-02, Vol.30 (1), p.16-22
• Main Authors: Quinaz Romana, Guilherme, Kislaya, Irina, Cunha Gonçalves, Susana, Salvador, Mário Rui, Nunes, Baltazar, Matias Dias, Carlos
• Format: Article
• Language: English
• Subjects: Age groups; Chronic conditions; Chronic illnesses; Comorbidity; Health care; Health care expenditures; Health care policy; Health policy; Multimorbidity; Patients; Primary care; Public health; Regression analysis; Regression models; Social factors; Socioeconomics
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckz118

Abstract Background The existence of multiple chronic conditions in the same patient is a public health problem increasingly recognized as relevant to health systems. Individuals with multimorbidity have additional health needs, which imply a heavy burden in healthcare use. It is estimated that between 70% and 80% of the total health expenditure is used with chronic conditions. Patients with multimorbidity are responsible for up to 75% of primary care appointments. These patients are also high hospital users, with up to 14.6 times more risk of hospitalization. Methods This study analyses the association between healthcare use and multimorbidity in the Portuguese population aged 25–74 years old. The association between socioeconomic variables and healthcare use was studied, based on data from the first Portuguese Health Examination Survey using a logistic regression model, stratified by sex and adjusted for socioeconomic confounding variables. Results In patients with multimorbidity, there was a greater use of primary healthcare consultations, medical or surgical specialist consultations and hospitalizations. An association was established between female, older age groups and lower educational levels, and increased healthcare use. When adjusted to socioeconomic variables, the likelihood of using healthcare services can be as high as 3.5 times, when compared to patients without chronic conditions. Conclusion Our results show a greater healthcare use in multimorbidity patients, both in primary and hospital care. The availability of scientific evidence regarding the use of healthcare services by multimorbidity patients may support health policy changes, which could allow a more efficient management of these patients.