In this section
@article{Lee:2015:10.1371/journal.pone.0127199,
author = {Lee, T and Millett},
doi = {10.1371/journal.pone.0127199},
journal = {PLOS One},
title = {Impact of noncommunicable disease multimorbidity onhealthcare utilisation and out-of-pocket expenditures in middle-income countries: cross sectional analysis},
url = {http://dx.doi.org/10.1371/journal.pone.0127199},
volume = {10},
year = {2015}
}
TY - JOUR
AB - BackgroundThe burden of non-communicable disease (NCDs) has grown rapidly in low- and middle-income countries (LMICs), where populations are ageing, with rising prevalence of multimorbidity (more than two co-existing chronic conditions) that will significantly increase pressure on already stretched health systems. We assess the impact of NCD multimorbidity on healthcare utilisation and out-of-pocket expenditures in six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa.MethodsSecondary analyses of cross-sectional data from adult participants (>18 years) in the WHO Study on Global Ageing and Adult Health (SAGE) 2007–2010. We used multiple logistic regression to determine socio-demographic correlates of multimorbidity. Association between the number of NCDs and healthcare utilisation as well as out-of-pocket spending was assessed using logistic, negative binominal and log-linear models.ResultsThe prevalence of multimorbidity in the adult population varied from 39% in Ghana to 336% in Russia. Number of visits to doctors in primary and secondary care rose substantially for persons with increasing numbers of co-existing NCDs. Multimorbidity was associated with more outpatient visits in China (coefficient for number of NCD = 056, 95% CI = 046, 066), a higher likelihood of being hospitalised in India (AOR = 159, 95% CI = 145, 175), higher out-of-pocket expenditures for outpatient visits in India and China, and higher expenditures for hospital visits in Russia. Medicines constituted the largest proportion of out-of-pocket expenditures in persons with multimorbidity (883% for outpatient, 559% for inpatient visit in China) in most countries.ConclusionMultimorbidity is associated with higher levels of healthcare utilisation and greater financial burden for individuals in middle-income countries. Our study supports the WHO call for universal health insurance and health service coverage in LMICs, particularly for vulnerable groups su
AU - Lee,T
AU - Millett
DO - 10.1371/journal.pone.0127199
PY - 2015///
SN - 1932-6203
TI - Impact of noncommunicable disease multimorbidity onhealthcare utilisation and out-of-pocket expenditures in middle-income countries: cross sectional analysis
T2 - PLOS One
UR - http://dx.doi.org/10.1371/journal.pone.0127199
UR - http://hdl.handle.net/10044/1/23948
VL - 10
ER -