Multimorbidity is associated with better quality of care among vulnerable elders.

Multimorbidity is associated with better quality of care among vulnerable elders. Research Abstract Details 

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Multimorbidity is associated with better quality of care among vulnerable elders. Abstract Text:

BACKGROUND: Older patients with multiple chronic conditions may be at higher risk of receiving poorer overall quality of care compared with those with single or no chronic conditions. Possible reasons include competing guidelines for individual conditions, burden of numerous recommendations, and difficulty implementing treatments for multiple conditions. OBJECTIVES: We sought to determine whether coexisting combinations of 8 common chronic conditions (hypertension, coronary artery disease, chronic obstructive pulmonary disease, osteoarthritis, diabetes mellitus, depression, osteoporosis, and having atrial fibrillation or congestive heart failure) are associated with overall quality of care among vulnerable older patients. MATERIALS AND METHODS: Using an observational cohort study, we enrolled 372 community-dwelling persons 65 years of age or older who were at increased risk for death or functional decline within 2 years. We included (1) a comprehensive measure (% of quality indicators satisfied) of quality of medical and geriatric care that accounted for patient preference and appropriateness in light of limited life expectancy and advanced dementia, and (2) a measure of multimorbidity, either as a simple count of conditions or as a combination of specific conditions. RESULTS:: Multimorbidity was associated with greater overall quality scores: mean proportion of quality indicators satisfied increased from 47% for elders with none of the prespecified conditions to 59% for those with 5 or 6 conditions (P < 0.0001), after controlling for number of office visits. Patients with greater multimorbidity also received care that was better than would be expected based on the specific set of quality indicators they triggered. CONCLUSIONS: Among older persons at increased risk of death or functional decline, multimorbidity results in better, rather than worse, quality of care.

Multimorbidity is associated with better quality of care among vulnerable elders. Publishing Authors By Initials

For similar persons: vulnerable populations research abstracts see: persons: vulnerable populations research

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Multimorbidity is associated with better quality of care among vulnerable elders. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Medical care

VOLUME: 45

Page Numbers: 480-8

Journal Abbreviation:

ISSN: 0025-7079

DAY: 3

MONTH: Jun

YEAR: 2007

Multimorbidity is associated with better quality of care among vulnerable elders. Information

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LANGUAGE: eng

NlmUniqueID: 230027

Multimorbidity is associated with better quality of care among vulnerable elders. Keywords Mesh Terms:

KEYWORDS: Vulnerable Populations

MESH TERMS: epidemiology

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Grant and Affiliation Information for Multimorbidity is associated with better quality of care among vulnerable elders.

AFFILIATION: David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1687, USA. lmin@mednet.ucla.edu

Country: United States

AGENCY: United States BHP

GRANT: PE-19001

ACRONYM: PE

MEDLINETA: Med Care

REFSOURCE: Med Care. 2007 Jun;45(6):477-9

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