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Exploring multimorbidity clusters in relation to healthcare use and its impact on self-rated health among older people in India

Ansari, Salmaan, Anand, Abhishek, Hossain, Babul (2023) Exploring multimorbidity clusters in relation to healthcare use and its impact on self-rated health among older people in India. PLOS Global Public Health, 3 (12). Article Number e0002330. ISSN 2767-3375. (doi:10.1371/journal.pgph.0002330) (KAR id:104457)


The conventional definition of multimorbidity may not address the complex treatment needs resulting from interactions between multiple conditions, impacting self-rated health (SRH). In India, there is limited research on healthcare use and SRH considering diverse disease combinations in individuals with multimorbidity. This study aims to identify multimorbidity clusters related to healthcare use and determine if it improves the self-rated health of individuals in different clusters. This study extracted information from cross-sectional data of the first wave of the Longitudinal Ageing Study in India (LASI), conducted in 2017–18. The study participants were 31,373 people aged ≥ 60 years. A total of nineteen chronic diseases were incorporated to identify the multimorbidity clusters using latent class analysis (LCA) in the study. Multivariable logistic regression was used to examine the association between identified clusters and healthcare use. A propensity score matching (PSM) analysis was utilised to further examine the health benefit (i.e., SRH) of using healthcare in each identified cluster. LCA analysis identified five different multimorbidity clusters: relatively healthy’ (68.72%), ‘metabolic disorder (16.26%), ‘hypertension-gastrointestinal-musculoskeletal’ (9.02%), ‘hypertension-gastrointestinal’ (4.07%), ‘complex multimorbidity’ (1.92%). Older people belonging to the complex multimorbidity [aOR:7.03, 95% CI: 3.54–13.96] and hypertension-gastrointestinal-musculoskeletal [aOR:3.27, 95% CI: 2.74–3.91] clusters were more likely to use healthcare. Using the nearest neighbor matching method, results from PSM analysis demonstrated that healthcare use was significantly associated with a decline in SRH across all multimorbidity clusters. Findings from this study highlight the importance of understanding multimorbidity clusters and their implications for healthcare utilization and patient well-being. Our findings support the creation of clinical practice guidelines (CPGs) focusing on a patient-centric approach to optimize multimorbidity management in older people. Additionally, finding suggest the urgency of inclusion of counseling and therapies for addressing well-being when treating patients with multimorbidity.

Item Type: Article
DOI/Identification number: 10.1371/journal.pgph.0002330
Subjects: R Medicine > R Medicine (General)
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Funders: University of Kent (
Depositing User: Salmaan Ansari
Date Deposited: 02 Jan 2024 14:20 UTC
Last Modified: 09 Feb 2024 14:39 UTC
Resource URI: (The current URI for this page, for reference purposes)

University of Kent Author Information

Ansari, Salmaan.

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