Abstract
Health systems face multimorbidity as the leading cause of the burden of disease and demand for healthcare services. Although non-communicable diseases are well known, and countries in Latin America have implemented strategies to its approach, tackling multimorbidity is still a challenge and an emerging topic. In response to this, Centro de Innovación en Salud ANCORA UC, in association with Servicio de Salud Metropolitano Sur Oriente and the National Health Fund, implemented a pilot study a Multimorbidity Patient-Centered Care Model in the health network. The objective was to evaluate the health care services utilization and mortality. The authors performed a cohort study with adults with non-communicable diseases, stratified by ACG® System. Analysis used logistic regression, adjusted by confounding variables. The intervened group had a significantly lower incidence of hospital admissions, length of stay, number of consultancies to hospital emergency, and number of consultancies to primary care emergency than the control group. Further, it was associated with significantly less mortality (OR 0.54; 95% CI 0.47 – 0.63). Barriers and facilitators proper from a complex intervention were approached. The model showed positive results in mortality and health services utilization. A description is provided to contribute to this emerging topic and facilitate its reproducibility. Key words: Multimorbidity, patient-centered care, risk stratification, impact analysis.
Highlights
Multimorbidity has become the first cause of the burden of disease and the primary determinant of demand for healthcare services in the health systems worldwide (Hajat and Stein, 2018)
The negative impact of multimorbidity decreases the quality of life at mid-life (Kanesarajah et al, 2018), it leads to higher mortality rates (age at death: increased in 6,3 with four or more noncommunicable diseases (NCDs) (Diane Zheng et al, 2021; Menotti et al, 2021) and greater healthcare services utilization
The description provided in this study about the core elements, the intervention strategies, and the implementation process could be taken from other countries of the region that need to start the transition to a multimorbidity approach
Summary
Multimorbidity has become the first cause of the burden of disease and the primary determinant of demand for healthcare services in the health systems worldwide (Hajat and Stein, 2018). Demographic change, modern lifestyles, and increased life expectancy have contributed to a high prevalence of multimorbidity, especially in 65 years of age patients (Leijten et al, 2018; Margozzini and Passi, 2018; Nguyen et al, 2019; Palmer et al, 2018). The negative impact of multimorbidity decreases the quality of life at mid-life (Kanesarajah et al, 2018), it leads to higher mortality rates (age at death: increased in 6,3 with four or more NCDs (Diane Zheng et al, 2021; Menotti et al, 2021) and greater healthcare services utilization, (de Souza and Braga, 2020; Heins et al, 2020; Leijten et al, 2018)
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