The association between multimorbidity and primary healthcare utilization in South-Eastern Norway Regional Health Authority

Abstract

Background: Multimorbidity is one of the greatest health-related challenges worldwide. Multimorbidity is associated with several outcomes, such as lower quality of life and higher disability. The main aim of this study was to explore the association between multimorbidity and the use of healthcare services in primary healthcare. Method: In a register-based, cross-sectional study we extracted data on 6 diseases and on the utilization of primary healthcare. Data were obtained from Norwegian national administrative and health registers and provided to the researchers by the Norwegian Institute of Public Health (NIPH). The study population consisted of people aged  65 years old, living in the South-Eastern Norway Regional Health Authority in Norway in 2016. We analyzed our data according to the number of morbidities, sex, age, marital status, and county of residents. We defined multimorbidity as the presence of two or more diseases. The association between multimorbidity and primary healthcare utilization was explored using Poisson regression. Results: The study population included 422 964 individuals. First, this study found that the prevalence of multimorbidity was 13.9 % among patients aged  65. Second, age was found to be the strongest predictor of multimorbidity. Third, primary healthcare consultations were found to significantly increase among people with multimorbidity ( 2 diseases) versus people with zero or one of the predefined conditions. The number of diseases seemed to be approximately linear associated with the number of primary care consultations. The effect of multimorbidity in healthcare utilization occurred independently of age, marital status, gender, and county of residents. Forth, there were significant differences in healthcare utilization across counties in South-Eastern Norway Regional Health Authority. Telemark was the region with the highest utilization rates and Oslo with the lowest. Conclusion: Multimorbidity was associated with a significant increase in primary healthcare utilization.