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Primary care and multimorbidity in six Latin American and Caribbean countries

OBJECTIVES: To describe patterns of multimorbidity in six diverse Latin American and Caribbean countries, examine its effects on primary care experiences, and assess its influence on reported overall health care assessments. METHODS: Cross-sectional data are from the Inter-American Development Bank&...

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Autores principales: Macinko, James, Andrade, Flavia C. D., Nunes, Bruno P., Guanais, Frederico C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Organización Panamericana de la Salud 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6393736/
https://www.ncbi.nlm.nih.gov/pubmed/31093232
http://dx.doi.org/10.26633/RPSP.2019.8
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author Macinko, James
Andrade, Flavia C. D.
Nunes, Bruno P.
Guanais, Frederico C.
author_facet Macinko, James
Andrade, Flavia C. D.
Nunes, Bruno P.
Guanais, Frederico C.
author_sort Macinko, James
collection PubMed
description OBJECTIVES: To describe patterns of multimorbidity in six diverse Latin American and Caribbean countries, examine its effects on primary care experiences, and assess its influence on reported overall health care assessments. METHODS: Cross-sectional data are from the Inter-American Development Bank's international primary care survey, conducted in 2013/2014, and represent the adult populations of Brazil, Colombia, El Salvador, Jamaica, Mexico and Panama. Robust Poisson regression models were used to estimate the extent to which those with multimorbidity receive adequate and appropriate primary care, have confidence in managing their health condition, and are able to afford needed medical care. RESULTS: The prevalence of multimorbidity ranged from 17.5% in Colombia to 37.3% in Jamaica. Most of the examined conditions occur along with others, with diabetes and heart disease being the two problems most associated with other conditions. The proportions of adults with high out-of-pocket payments, problems paying their medical bills, seeing multiple doctors, and being in only fair/poor health were higher among those with greater levels of multimorbidity and poorer primary care experiences. Multimorbidity and difficulties with primary care were positively associated with trouble paying for medical care and managing one's conditions. Nonetheless, adults with multimorbidity were more likely to have received lifestyle advice and to be up to date with preventive exams. CONCLUSIONS: Multimorbidity is reported frequently. Providing adequate care for the growing number of such patients is a major challenge facing most health systems, which will require considerable strengthening of primary care along with financial protection for those most in need.
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spelling pubmed-63937362019-05-15 Primary care and multimorbidity in six Latin American and Caribbean countries Macinko, James Andrade, Flavia C. D. Nunes, Bruno P. Guanais, Frederico C. Rev Panam Salud Publica Original Research OBJECTIVES: To describe patterns of multimorbidity in six diverse Latin American and Caribbean countries, examine its effects on primary care experiences, and assess its influence on reported overall health care assessments. METHODS: Cross-sectional data are from the Inter-American Development Bank's international primary care survey, conducted in 2013/2014, and represent the adult populations of Brazil, Colombia, El Salvador, Jamaica, Mexico and Panama. Robust Poisson regression models were used to estimate the extent to which those with multimorbidity receive adequate and appropriate primary care, have confidence in managing their health condition, and are able to afford needed medical care. RESULTS: The prevalence of multimorbidity ranged from 17.5% in Colombia to 37.3% in Jamaica. Most of the examined conditions occur along with others, with diabetes and heart disease being the two problems most associated with other conditions. The proportions of adults with high out-of-pocket payments, problems paying their medical bills, seeing multiple doctors, and being in only fair/poor health were higher among those with greater levels of multimorbidity and poorer primary care experiences. Multimorbidity and difficulties with primary care were positively associated with trouble paying for medical care and managing one's conditions. Nonetheless, adults with multimorbidity were more likely to have received lifestyle advice and to be up to date with preventive exams. CONCLUSIONS: Multimorbidity is reported frequently. Providing adequate care for the growing number of such patients is a major challenge facing most health systems, which will require considerable strengthening of primary care along with financial protection for those most in need. Organización Panamericana de la Salud 2019-01-25 /pmc/articles/PMC6393736/ /pubmed/31093232 http://dx.doi.org/10.26633/RPSP.2019.8 Text en https://creativecommons.org/licenses/by-nc-nd/3.0/igo/legalcode This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited. No modifications or commercial use of this article are permitted. In any reproduction of this article there should not be any suggestion that PAHO or this article endorse any specific organization or products. The use of the PAHO logo is not permitted. This notice should be preserved along with the article's original URL.
spellingShingle Original Research
Macinko, James
Andrade, Flavia C. D.
Nunes, Bruno P.
Guanais, Frederico C.
Primary care and multimorbidity in six Latin American and Caribbean countries
title Primary care and multimorbidity in six Latin American and Caribbean countries
title_full Primary care and multimorbidity in six Latin American and Caribbean countries
title_fullStr Primary care and multimorbidity in six Latin American and Caribbean countries
title_full_unstemmed Primary care and multimorbidity in six Latin American and Caribbean countries
title_short Primary care and multimorbidity in six Latin American and Caribbean countries
title_sort primary care and multimorbidity in six latin american and caribbean countries
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6393736/
https://www.ncbi.nlm.nih.gov/pubmed/31093232
http://dx.doi.org/10.26633/RPSP.2019.8
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