Occurrence, determinants and outcomes of multimorbidity in primary care:the Indian landscape

This thesis describes the first ever landscape of multimorbidity, (i.e. the co-occurrence of two or more long-term medical conditions) among patients attending both public and private primary care settings in India. The objectives of the study were to estimate the prevalence and correlates of multimorbidity among patients presenting to private and public primary care settings, identify the commonly occurring combinations (pattern), assess their severity and analyse their health care utilisation and quality of life in relation to multimorbidity. Furtheremore, the relation of multimorbidity with health care utilisation and quality of life in these individuals is investigated.The study findings reveal that multimorbidity is equally common in low- and middle-income countries with one third of patients having the problem. The findings of higher prevalence of multimorbidity and hospitalizations in higher SES individuals contrast with findings in Western countries, where lower social economic status (SES) is associated with a greater morbidity burden