Imperial College London
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Dr Thomas Hone

Faculty of Medicine, School of Public Health

Lecturer in Global Health Systems Research
 
 
 
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t.hone

 
 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hone:2021:10.1186/s12889-021-11328-0,
author = {Hone, T and Stokes, J and Trajman, A and Saraceni, V and Coeli, CM and Rasella, D and Durovni, B and Millett, C},
doi = {10.1186/s12889-021-11328-0},
journal = {BMC Public Health},
title = {Racial and socioeconomic disparities in multimorbidity and associated healthcare utilisation and outcomes in Brazil: a cross-sectional analysis of three million individuals},
url = {http://dx.doi.org/10.1186/s12889-021-11328-0},
volume = {21},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:Evidence is limited on racial/ethnic group disparities in multimorbidity and associated health outcomes in low- and middle-income countries hampering effective policies and clinical interventions to address health inequalities.Methods:This study assessed race/ethnic and socioeconomic disparities in the prevalence of multimorbidity and associated healthcare utilisation, costs and death in Rio de Janeiro, Brazil. A cross-sectional analysis was carried out of 3,027,335 individuals registered with primary healthcare (PHC) services. Records included linked data to hospitalisation, mortality, and welfare-claimant (Bolsa Família) records between 1 Jan 2012 and 31 Dec 2016. Logistic and Poisson regression models were carried out to assess the likelihood of multimorbidity (two or more diagnoses out of 53 chronic conditions), PHC use, hospital admissions and mortality from any cause. Interactions were used to assess disparities.Results:In total 13,509,633 healthcare visits were analysed identifying 389,829 multimorbid individuals (13%). In adjusted regression models, multimorbidity was associated with lower education (Adjusted Odds Ratio (AOR): 1.26; 95%CI: 1.23,1.29; compared to higher education), Bolsa Família receipt (AOR: 1.14; 95%CI: 1.13,1.15; compared to non-recipients); and black race/ethnicity (AOR: 1.05; 95%CI: 1.03,1.06; compared to white). Multimorbidity was associated with more hospitalisations (Adjusted Rate Ratio (ARR): 2.75; 95%CI: 2.69,2.81), more PHC visits (ARR: 3.46; 95%CI: 3.44,3.47), and higher likelihood of death (AOR: 1.33; 95%CI: 1.29,1.36). These associations were greater for multimorbid individuals with lower educational attainment (five year probability of death 1.67% (95%CI: 1.61,1.74%) compared to 1.13% (95%CI: 1.02,1.23%) for higher education), individuals of black race/ethnicity (1.48% (95%CI: 1.41,1.55%) compared to 1.35% (95%CI: 1.31,1.40%) for white) and individuals in receipt of welfare (1.89% (95%CI: 1.77,2.00%) co
AU  - Hone,T
AU  - Stokes,J
AU  - Trajman,A
AU  - Saraceni,V
AU  - Coeli,CM
AU  - Rasella,D
AU  - Durovni,B
AU  - Millett,C
DO  - 10.1186/s12889-021-11328-0
PY  - 2021///
SN  - 1471-2458
TI  - Racial and socioeconomic disparities in multimorbidity and associated healthcare utilisation and outcomes in Brazil: a cross-sectional analysis of three million individuals
T2  - BMC Public Health
UR  - http://dx.doi.org/10.1186/s12889-021-11328-0
UR  - http://hdl.handle.net/10044/1/90675
VL  - 21
ER  -
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