Quality of care measures in multimorbidity.

Background: Multimorbidity is increasingly prevalent in general practice, creating challenges for assessment and management. This paper aims to explore the methods used to assess the quality of care for primary care patients with multimorbidity. Methods: A systematic review of the published literature was conducted using major medical databases (Medline, Scopus, Embase and CINAHL). Measures were then categorised using the Donabedian framework. Results: Twenty-seven studies were included. All of the process measures were disease-specific. Some non-diseasespecific measures of outcome were identified, including functional outcomes, healthcare utilisation and patient-rated measures. Discussion: There has been a reliance on measures of process and outcome for single conditions in the assessment of quality of care. A broader, more comprehensive range of measures of structure, process and outcome is needed to fully evaluate the care of patients with multimorbidity