Publication Details
Brett, T.,
Arnold-Reed, D.,
Troeung, L.,
Bulsara, M.,
Williams, A.,
&
Moorhead, R. G.
(2014).
Multimorbidity in a marginalised, street-health Australian population: a retrospective cohort study.
BMJ Open, 4 (8), e005461.
https://doi.org/10.1136/bmjopen-2014-005461
Abstract
OBJECTIVES:
Demographic and presentation profile of patients using an innovative mobile outreach clinic compared with mainstream practice.
DESIGN:
Retrospective cohort study.
SETTING:
Primary care mobile street health clinic and mainstream practice in Western Australia.
PARTICIPANTS:
2587 street health and 4583 mainstream patients.
MAIN OUTCOME MEASURES:
Prevalence and patterns of chronic diseases in anatomical domains across the entire age spectrum of patients and disease severity burden using Cumulative Illness Rating Scale (CIRS).
RESULTS:
Multimorbidity (2+ CIRS domains) prevalence was significantly higher in the street health cohort (46.3%, 1199/2587) than age-sex-adjusted mainstream estimate (43.1%, 2000/4583), p=0.011. Multimorbidity prevalence was significantly higher in street health patients(37.7%, 615/1649) compared with age-sex-adjusted mainstream patients (33%, 977/2961), p=0.003 but significantly lower if 65+ years (62%, 114/184 vs 90.7%, 322/355, p
CONCLUSIONS:
Age-sex-adjusted multimorbidity prevalence and disease severity is higher in the street health cohort. Earlier onset (23-34 years) multimorbidity is found in the street health cohort but prevalence is lower in 65+ years than in mainstream patients. Multimorbidity prevalence is higher for Aboriginal patients of all ages.
Keywords
primary care, chronic disease, multimorbidity
