Title
Primary care and multimorbidity in six Latin American and Caribbean countries
Date Issued
01 January 2019
Access level
metadata only access
Resource Type
journal article
Author(s)
Macinko J.
Andrade F.C.D.
Nunes B.P.
Inter-American Development Bank
Publisher(s)
Pan American Health Organization
Abstract
Objectives: To describe patterns of multimorbidity in six diverse Latin American and Caribbean countries, examine its effects on primary care experiences, and assess its infuence 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 confdence 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 fnancial protection for those most in need.
Volume
43
Language
English
OCDE Knowledge area
Ciencias de la salud
Scopus EID
2-s2.0-85068268254
Source
Revista Panamericana de Salud Publica/Pan American Journal of Public Health
Resource of which it is part
Revista Panamericana de Salud Publica/Pan American Journal of Public Health
ISSN of the container
10204989
Source funding
Inter-American Development Bank
Sources of information: Directorio de Producción Científica Scopus