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Research

Multimorbidity within households and use of health and social care

Mai Stafford, Sarah Deeny, Kathryn Dreyer and Shand Jenny
BJGP Open 24 November 2020; BJGPO.2020.0134. DOI: https://doi.org/10.3399/BJGPO.2020.0134
Mai Stafford
1 The Health Foundation, London, United Kingdom
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  • For correspondence: mai.stafford@health.org.uk
Sarah Deeny
2 The Health Foundation, London, United Kingdom
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Kathryn Dreyer
3 The Health Foundation, London, United Kingdom
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Shand Jenny
4 UCL Partners, London, United Kingdom
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Abstract

Background: The daily management of long-term conditions falls primarily on individuals and informal carers, but the impact of household context on health and social care activity among people with multimorbidity is understudied. Aim: To test whether co-residence with a multimorbid person (compared with a non-multimorbid co-resident) is associated with utilisation and cost of primary, community and secondary health care and formal social care. Design and Setting: Linked data from health providers and local government in Barking and Dagenham for a retrospective cohort of people aged 50+ in two-person households in 2016-2018. Methods: Two-part regression models were applied to estimate annualised use and cost of hospital, primary, community, mental health and social care by multimorbidity status of individuals and co-residents, adjusted for age, gender and deprivation. Applicability at the national level was tested using the Clinical Practice Research Datalink. Results: Over 45% of multimorbid people in two-person households were co-resident with another multimorbid person. They were 1.14 (95% CI 1.00, 1.30) times as likely to have community care activity and 1.24 (95% CI 0.99,1.54) times as likely to have mental health care activity compared to those co-resident with a healthy person. They had more primary care visits (8.5 (95% CI 8.2,8.8) vs 7.9 (95% CI 7.7,8.2)) and higher primary care costs. Outpatient care and elective admissions did not differ. Findings in national data were similar. Conclusions: Care utilisation for people with multimorbidity varies by household context. There may be potential for connecting health and community service input across household members.

  • Clinical (general)
  • Comorbidity
  • multiple conditions
  • comorbidity
  • inequalities
  • social context
  • Received August 4, 2020.
  • Accepted October 8, 2020.
  • Copyright © 2020, The Authors

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Accepted Manuscript
Multimorbidity within households and use of health and social care
Mai Stafford, Sarah Deeny, Kathryn Dreyer, Shand Jenny
BJGP Open 24 November 2020; BJGPO.2020.0134. DOI: 10.3399/BJGPO.2020.0134

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Accepted Manuscript
Multimorbidity within households and use of health and social care
Mai Stafford, Sarah Deeny, Kathryn Dreyer, Shand Jenny
BJGP Open 24 November 2020; BJGPO.2020.0134. DOI: 10.3399/BJGPO.2020.0134
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Keywords

  • Clinical (general)
  • Comorbidity
  • multiple conditions
  • inequalities
  • social context

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