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Curr Med Sci. 2018 Feb;38(1):184-190. doi: 10.1007/s11596-018-1863-8. Epub 2018 Mar 15.

Satisfaction about Patient-centeredness and Healthcare System among Patients with Chronic Multimorbidity.

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School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Guangdong Women's and Children's Hospital, Guangzhou, 511400, China.
Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, 30602, USA.
School of International Development and Global Studies, University of Ottawa, Ottawa, ON, K1H 8M5, Canada.
School of Politics and Public Administration, Southwest University of Political Science & Law, 401120, Chongqing, China.
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.


The aim of the present study was to measure the prevalence of multimorbidity in Bangladesh, India and China, and to assess the relationship between multimorbidity and patient's opinion regarding their involvement in healthcare decision-making and overall satisfaction of healthcare system. Cross-sectional data on 18 696 men and women aged 18 and above were collected from the World Health Survey of World Health Organization (WHO). Outcome variables were subjective rating of (1) healthcare system's ability to involve patients in decision-making, and (2) satisfaction with the way healthcare system runs in the country. Self-reported chronic conditions were used to measure the prevalence of multimorbidity. Out of 9 chronic conditions, back pain, arthritis, and chronic cough appeared to be the most prevalent ones among majority of the participants. About one-third of the participants in China (30.7%) and two-thirds in Bangladesh (66.1%) and India (66.6%) reported having at least one chronic illness. Prevalence of multimorbidity was highest in India (34.3%) followed by Bangladesh (28.8%) and China (14.3%). In Bangladesh, India and China, respectively 70.5%, 41.7%, 61.3% women and 54.5%, 42.8% and 58.8 % men expressed dissatisfaction regarding the way healthcare system runs in their country. In Bangladesh and India, men who were living with multimorbidity were more likely to rate the patient-centeredness as "bad" than those who had no disease illness. This study suggests that the prevalence of multimorbidity was remarkably high especially in Bangladesh and India. Higher likelihood of dissatisfaction about healthcare system among multimorbid patients might be indicative of inadequacy in the provision of care in qualitative and quantitative terms.


World Health Survey; healthcare; multimorbidity; non-communicable chronic diseases; patient satisfaction

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