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Determinants associated with deprivation in multimorbid patients in primary care—A cross-sectional study in Switzerland

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  • Silja Leiser
  • Anouk Déruaz-Luyet
  • A Alexandra N’Goran
  • Jérôme Pasquier
  • Sven Streit
  • Stefan Neuner-Jehle
  • Andreas Zeller
  • Dagmar M Haller
  • Lilli Herzig
  • Patrick Bodenmann

Abstract

Background: Deprivation usually encompasses material, social, and health components. It has been shown to be associated with greater risks of developing chronic health conditions and of worse outcome in multimorbidity. The DipCare questionnaire, an instrument developed and validated in Switzerland for use in primary care, identifies patients subject to potentially higher levels of deprivation. Objectives: To identifying determinants of the material, social, and health profiles associated with deprivation in a sample of multimorbid, primary care patients, and thus set priorities in screening for deprivation in this population. Design: Secondary analysis from a nationwide cross-sectional study in Switzerland. Participants: A random sample of 886 adult patients suffering from at least three chronic health conditions. Main measures: The outcomes of interest were the patients’ levels of deprivation as measured using the DipCare questionnaire. Classification And Regression Tree analysis identified the independent variables that separated the examined population into groups with increasing deprivation scores. Finally, a sensitivity analysis (multivariate regression) confirmed the robustness of our results. Key results: Being aged under 64 years old was associated with higher overall, material, and health deprivation; being aged over 77 years old was associated with higher social deprivation. Other variables associated with deprivation were the level of education, marital status, and the presence of depression or chronic pain. Conclusion: Specific profiles, such as being younger, were associated with higher levels of overall, material, and health deprivation in multimorbid patients. In contrast, patients over 77 years old reported higher levels of social deprivation. Furthermore, chronic pain and depression added to the score for health deprivation. It is important that GPs consider the possibility of deprivation in these multimorbid patients and are able to identify it, both in order to encourage treatment adherence and limit any forgoing of care for financial reasons.

Suggested Citation

  • Silja Leiser & Anouk Déruaz-Luyet & A Alexandra N’Goran & Jérôme Pasquier & Sven Streit & Stefan Neuner-Jehle & Andreas Zeller & Dagmar M Haller & Lilli Herzig & Patrick Bodenmann, 2017. "Determinants associated with deprivation in multimorbid patients in primary care—A cross-sectional study in Switzerland," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-12, July.
    • Handle: RePEc:plo:pone00:0181534
    DOI: 10.1371/journal.pone.0181534
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    References listed on IDEAS

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    1. Salmond, Clare & Crampton, Peter & King, Peter & Waldegrave, Charles, 2006. "NZiDep: A New Zealand index of socioeconomic deprivation for individuals," Social Science & Medicine, Elsevier, vol. 62(6), pages 1474-1485, March.
    2. Patrick Bodenmann & Bernard Favrat & Hans Wolff & Idris Guessous & Francesco Panese & Lilli Herzig & Thomas Bischoff & Alejandra Casillas & Thomas Golano & Paul Vaucher, 2014. "Screening Primary-Care Patients Forgoing Health Care for Economic Reasons," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    3. Sophia Chatelard & Patrick Bodenmann & Paul Vaucher & Lilli Herzig & Thomas Bischoff & Bernard Burnand, 2014. "General Practitioners Can Evaluate the Material, Social and Health Dimensions of Patient Social Status," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-8, January.
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    1. María Pilar Botija Yagüe & Sofía Sorbet-Santiago & Javier Díaz-Carnicero & Silvia González-de-Julián & Ruth Usó-Talamantes, 2022. "Modelling Deprivation Level and Multimorbidity in a Health District," Mathematics, MDPI, vol. 10(4), pages 1-14, February.

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