Determinants associated with deprivation in multimorbid patients in primary care-A cross-sectional study in Switzerland.

Leiser, Silja; Déruaz-Luyet, Anouk; N'Goran, A Alexandra; Pasquier, Jérôme; Streit, Sven; Neuner-Jehle, Stefan; Zeller, Andreas; Haller, Dagmar M; Herzig, Lilli; Bodenmann, Patrick (2017). Determinants associated with deprivation in multimorbid patients in primary care-A cross-sectional study in Switzerland. PLoS ONE, 12(7), e0181534. Public Library of Science 10.1371/journal.pone.0181534

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BACKGROUND Deprivation usually encompasses material, social, and health components. It has been shown to be associated with greater risks of developing chronic health conditions and of worse outcome in multimorbidity. The DipCare questionnaire, an instrument developed and validated in Switzerland for use in primary care, identifies patients subject to potentially higher levels of deprivation. OBJECTIVES To identifying determinants of the material, social, and health profiles associated with deprivation in a sample of multimorbid, primary care patients, and thus set priorities in screening for deprivation in this population. DESIGN Secondary analysis from a nationwide cross-sectional study in Switzerland. PARTICIPANTS A random sample of 886 adult patients suffering from at least three chronic health conditions. MAIN MEASURES The outcomes of interest were the patients' levels of deprivation as measured using the DipCare questionnaire. Classification And Regression Tree analysis identified the independent variables that separated the examined population into groups with increasing deprivation scores. Finally, a sensitivity analysis (multivariate regression) confirmed the robustness of our results. KEY RESULTS Being aged under 64 years old was associated with higher overall, material, and health deprivation; being aged over 77 years old was associated with higher social deprivation. Other variables associated with deprivation were the level of education, marital status, and the presence of depression or chronic pain. CONCLUSION Specific profiles, such as being younger, were associated with higher levels of overall, material, and health deprivation in multimorbid patients. In contrast, patients over 77 years old reported higher levels of social deprivation. Furthermore, chronic pain and depression added to the score for health deprivation. It is important that GPs consider the possibility of deprivation in these multimorbid patients and are able to identify it, both in order to encourage treatment adherence and limit any forgoing of care for financial reasons.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Streit, Sven

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

24 Aug 2017 16:41

Last Modified:

09 Nov 2017 16:25

Publisher DOI:

10.1371/journal.pone.0181534

PubMed ID:

28738070

BORIS DOI:

10.7892/boris.102395

URI:

https://boris.unibe.ch/id/eprint/102395

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