The impact of socioeconomic factors on mortality in people with multimorbidity: a prospective cohort study

Background

Multimorbidity - the co-occurrence of two or more medical or psychiatric conditions - is of great concern worldwide because of its complexity, increasing prevalence and association with high mortality. Several studies suggest an overall prevalence of 23-38%, which is increasing with age. Multimorbidity entails challenges for the individual, the GP and the entire health care system.

Evidence suggests that lower socioeconomic status (SES) is a key determinant for multimorbidity. An inverse relationship between SES and chronic condition burden has been found across studies conducted in different countries using both neighbourhood and individual measures of SES. Nevertheles, studies focusing on the prognosis and based in primary care are still lacking.

A social gradient with increasing mortality rates is seen in lower socioeconomic groups for many single diseases, but we still lack knowledge on the socioeconomic inequalities in multimorbidity as most former studies have  focused mainly on single diseases.

Objectives

This Research Year project aims:

  • To investigate the impact of educational level as a measure of SES on mortality in people with multimorbidity while taking into account important confounders such as age, sex, marital status, lifestyle factors and disease severity.

Perspectives

This study will provide us with important knowledge on the prognosis of people with multimorbidity.

The impact of socioeconomic factors on the long-term prognosis has been examined for several single diseases. The study will explore how and how much socioeconomic factors may impact the mortality for multimorbid patients in a developed country like Denmark, where medical treatment is available to all residents.

We hope that the results may help assess how and where we need to allocate the resources to ensure that our limited health care resources are used in the best possible way.