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International Journal of Family MedicineVolume 2012 2012, Article ID 823294, 10 pages

Research Article

Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26506, USA

School of Social Work, Rutgers University, New Brunswick, NJ 08901, USA

HSR&D Center for Healthcare Knowledge Management, Veterans Administration New Jersey Healthcare System East Orange, NJ 07018, USA

Received 11 April 2012; Revised 6 October 2012; Accepted 21 October 2012

Academic Editor: Carolyn Chew-Graham

Copyright © 2012 Mayank Ajmera et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Individuals with multimorbidity are vulnerable to poor quality of care due to issues related to care coordination. Ambulatory care sensitive hospitalizations ACSHs are widely accepted quality indicators because they can be avoided by timely, appropriate, and high-quality outpatient care. Objective. To examine the association between multimorbidity, mental illness, and ACSH. Study Design. We used a longitudinal panel design with data from multiple years 2000–2005 of Medicare Current Beneficiary Survey. Individuals were categorized into three groups: 1 multimorbidity with mental illness MM-MI; 2 MM-no MI; 3 no MM. Multivariable logistic regressions were used to analyze the association between multimorbidity and ACSH. Results. Any ACSH rates varied from 10.8% in MM-MI group to 8.8% in MM-No MI group. Likelihood of any ACSH was higher among beneficiaries with MM-MI AOR = 1.62; 95% CI = 1.14, 2.30 and MM AOR = 1.54; 95% CI = 1.12, 2.11 compared to beneficiaries without multimorbidity. There was no statistically significant difference in likelihood of ACSH between MM-MI and MM-No MI groups. Conclusion. Multimorbidity with or without MI had an independent and significant association with any ACSH. However, presence of mental illness alone was not associated with poor quality of care as measured by ACSH.

Author: Mayank Ajmera, Tricia Lee Wilkins, Patricia A. Findley, and Usha Sambamoorthi



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