Patients with multimorbidity--two or more long-term medical conditions--have complex health care needs, often requiring higher levels of care than other patients. According to a new study, however, patients with multimorbidity in affluent areas receive longer doctor visits, greater perceived empathy, and more patient-centered care than comparable patients in socioeconomically deprived areas. Researchers in Scotland analyzed 659 routine visits to general practitioners in deprived and affluent areas, as well as patient ratings of general practitioner empathy. In affluent areas, multimorbid patients received longer consultations than other patients (13 minutes versus 9 minutes) while in deprived areas, consultation length was about the same for both groups (10 minutes). Similarly, patients with multimorbidity in affluent areas found GPs to be more empathetic and, according to video analysis, more attentive to their disease and illness experience. There were no such differences between similar groups in deprived areas. If primary care is to succeed in narrowing health inequalities, the authors state, action is needed to ensure that patients with multimorbidity in lower socioeconomic areas receive the same level of care and attention as patients in affluent areas.
Multimorbidity and Socioeconomic Deprivation in Primary Care Consultations
Stewart W Mercer, MBchB, PhD, et al
University of Glasgow, Glasgow, Scotland