TY  - JOUR
A1  - Knesebeck, Olaf von dem
A1  - Bickel, Horst
A1  - Fuchs, Angela
A1  - Gensichen, Jochen
A1  - Höfels, Susanne
A1  - Riedel-Heller, Steffi Gerlinde
A1  - König, Hans-Helmut
A1  - Mergenthal, Karola
A1  - Schön, Gerhard
A1  - Wegscheider, Karl
A1  - Weyerer, Siegfried
A1  - Wiese, Birgitt
A1  - Scherer, Martin
A1  - Bussche, Hendrik van den
A1  - Schäfer, Ingmar
T1  - Social inequalities in patient-reported outcomes among older multimorbid patients : results of the MultiCare cohort study
T2  - International journal for equity in health
N2  - Introduction: In this article three research questions are addressed: (1) Is there an association between socioeconomic status (SES) and patient-reported outcomes in a cohort of multimorbid patients? (2) Does the association vary according to SES indicator used (income, education, occupational position)? (3) Can the association between SES and patient-reported outcomes (self-rated health, health-related quality of life and functional status) be (partly) explained by burden of disease?
Methods: Analyses are based on the MultiCare Cohort Study, a German multicentre, prospective, observational cohort study of multimorbid patients from general practice. We analysed baseline data and data from the first follow-up after 15 months (N = 2,729). To assess burden of disease we used the patients’ morbidity data from standardized general practitioner (GP) interviews based on a list of 46 groups of chronic conditions including the GP’s severity rating of each chronic condition ranging from marginal to very severe.
Results: In the cross-sectional analyses SES was significantly associated with the patient-reported outcomes at baseline. Associations with income were more consistent and stronger than with education and occupational position. Associations were partly explained (17% to 44%) by burden of disease. In the longitudinal analyses only income (but not education and occupational position) was significantly related to the patient-reported outcomes at follow-up. Associations between income and the outcomes were reduced by 18% to 27% after adjustment for burden of disease.
Conclusions: Results indicate social inequalities in self-rated health, functional status and health related quality of life among older multimorbid patients. As associations with education and occupational position were inconsistent, these inequalities were mainly due to income. Inequalities were partly explained by burden of disease. However, even among patients with a similar disease burden, those with a low income were worse off in terms of the three patient-reported outcomes under study.
KW  - Socioeconomic status
KW  - Patient-reported outcomes
KW  - Multimorbid patients
KW  - Burden of disease
Y1  - 2015
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/37374
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-373749
SN  - 1475-9276
N1  - Copyright © von dem Knesebeck et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
VL  - 14
IS  - 17
PB  - BioMed Central
CY  - London
ER  -