Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey

Qual Life Res. 2013 May;22(4):791-9. doi: 10.1007/s11136-012-0214-7. Epub 2012 Jun 9.

Abstract

Purpose: We assessed the associations between multimorbidity and health-related quality of life (HRQL), and healthcare utilization, based on 16 common self-reported chronic conditions.

Methods: A cross-sectional questionnaire survey including the EQ-5D was conducted in a sample of the general population of adults (≥18 years) living in Alberta, Canada. Multiple linear and logistic regressions were used to assess the association between multiple chronic conditions and HRQL, hospitalization and emergency department (ED) use.

Results: A total of 4,946 respondents reported their HRQL, noting problems mostly with pain or discomfort (48.0%). All chronic conditions were associated with a clinically important reduction in HRQL, the highest burden with anxiety or depression (-0.19, 95% CI -0.21, -0.16) and chronic pain (-0.19, 95% CI -0.21, -0.17). Multimorbidity was associated with a clinically important reduction in the EQ-5D index score (-0.12, 95% CI -0.14, -0.11) and twice the likelihood of being hospitalized (OR = 2.2, 95% CI 1.7, 2.9) or having an ED visit (OR = 1.8, 95% CI 1.4, 2.2).

Conclusions: Pain or discomfort is a common problem in people living with chronic conditions, and the existence of multimorbidity in these individuals is associated with a reduction in the HRQL as well as frequent hospitalization and emergency department visits.

MeSH terms

  • Adult
  • Aged
  • Alberta / epidemiology
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Canada / epidemiology
  • Chronic Disease / epidemiology
  • Chronic Disease / psychology*
  • Chronic Pain / epidemiology
  • Chronic Pain / psychology
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / psychology
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Status*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Linear Models
  • Logistic Models
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Middle Aged
  • Quality of Life / psychology*
  • Self Report
  • Sickness Impact Profile*
  • Surveys and Questionnaires