Please use this identifier to cite or link to this item: https://doi.org/10.3390/jcm10081782
Title: Assessing the impact of multi-morbidity and related constructs on patient reported safety in primary care: Generalized structural equation modelling of observational data
Authors: Ricci-Cabello, Ignacio
Yañez-Juan, A.M.
Fiol-deRoque, Maria A.
Leiva, Alfonso
Llobera Canaves, J.
Parmentier, Fabrice B. R.
Valderas, Jose M. 
Keywords: Latent class analysis
Multimorbidity
Patient safety
Polypharmacy
Primary care
Structural equation model
Issue Date: 20-Apr-2021
Publisher: MDPI
Citation: Ricci-Cabello, Ignacio, Yañez-Juan, A.M., Fiol-deRoque, Maria A., Leiva, Alfonso, Llobera Canaves, J., Parmentier, Fabrice B. R., Valderas, Jose M. (2021-04-20). Assessing the impact of multi-morbidity and related constructs on patient reported safety in primary care: Generalized structural equation modelling of observational data. Journal of Clinical Medicine 10 (8) : 1782. ScholarBank@NUS Repository. https://doi.org/10.3390/jcm10081782
Rights: Attribution 4.0 International
Abstract: We aimed to examine the complex relationships between patient safety processes and outcomes and multimorbidity using a comprehensive set of constructs: multimorbidity, polyphar-macy, discordant comorbidity (diseases not sharing either pathogenesis nor management), morbidity burden and patient complexity. We used cross-sectional data from 4782 patients in 69 primary care centres in Spain. We constructed generalized structural equation models to examine the associations between multimorbidity constructs and patient-reported patient safety (PREOS-PC questionnaire). These associations were modelled through direct and indirect (mediated by increased interactions with healthcare) pathways. For women, a consistent association between higher levels of the multimorbidity constructs and lower levels of patient safety was observed via either pathway. The findings for men replicated these observations for polypharmacy, morbidity burden and patient complexity via indirect pathways. However, direct pathways showed unexpected associations between higher levels of multimorbidity and better safety. The consistent association between multimorbidity constructs and worse patient safety among women makes it advisable to target this group for the development of interventions, with particular attention to the role of comorbidity discordance. Further research, particularly qualitative research, is needed for clarifying the complex associations among men. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Source Title: Journal of Clinical Medicine
URI: https://scholarbank.nus.edu.sg/handle/10635/232103
ISSN: 2077-0383
DOI: 10.3390/jcm10081782
Rights: Attribution 4.0 International
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