Care Experiences in Primary Health Care Among Older Adults Living with Multimorbidity (ELSI-Brazil Study)
1
Faculty of Medicine, Federal University of Goias, Goiânia, Brazil
2
Postgraduate Program in Public Health, Intitute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
3
Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A2975
ABSTRACT
INTRODUCTION:
Care for people living with multimorbidity demands continuous, integrated, and comprehensive approaches and Primary Health Care (PHC) plays a central role. Our aim was to analyse the association between the occurrence of multimorbidity and care experiences in primary health care among older adults.
METHODS:
Cross-sectional study using data from the Brazilian Longitudinal Study of Ageing (ELSI-Brazil; 2. wave, 2019-2021), with a sample of 6,929 participants aged 60 years or older. PHC experiences were assessed using 12 self-reported indicators grouped into four domains: first-contact access, longitudinality, communication and coordination. Each item was classified as positive or negative based on Likert responses. Positive responses were summed to create a continuous score ranging from 0 to 12, with higher values indicating better primary care attributes. The main explanatory variable was the presence of multimorbidity, defined as having two or more chronic conditions from a list of 16 occurring in the same individual. Sociodemographic covariates, as well as variables related to health services and health conditions, were also included.
RESULTS:
Multimorbidity was more prevalent among women (53.3%), individuals with 60-69 years (50.3%) and those with lower educational levels (38.8%). Older adults with MM reported better care experiences in primary health care than those without MM (8.70±2.83 vs. 8.42±3.37, p< 0.001). Additionally, household registration in the Family Health Strategy (Brazilian Primary Care model) was associated with better PHC experiences among older adults with MM (9.00±2.68 vs. 8.67±3.06; p< 0.001). In both situations, the attributes with the highest scores were those related to longitudinality, communication and care coordination (p< 0.001).
CONCLUSIONS:
Older adults living with multimorbidity reported more positive primary care experiences, particularly when registered with the Family Health Strategy. Higher scores in longitudinality, communication and care coordination suggest that strengthened and continuous relationships in PHC may play a protective role for this population.
Care for people living with multimorbidity demands continuous, integrated, and comprehensive approaches and Primary Health Care (PHC) plays a central role. Our aim was to analyse the association between the occurrence of multimorbidity and care experiences in primary health care among older adults.
METHODS:
Cross-sectional study using data from the Brazilian Longitudinal Study of Ageing (ELSI-Brazil; 2. wave, 2019-2021), with a sample of 6,929 participants aged 60 years or older. PHC experiences were assessed using 12 self-reported indicators grouped into four domains: first-contact access, longitudinality, communication and coordination. Each item was classified as positive or negative based on Likert responses. Positive responses were summed to create a continuous score ranging from 0 to 12, with higher values indicating better primary care attributes. The main explanatory variable was the presence of multimorbidity, defined as having two or more chronic conditions from a list of 16 occurring in the same individual. Sociodemographic covariates, as well as variables related to health services and health conditions, were also included.
RESULTS:
Multimorbidity was more prevalent among women (53.3%), individuals with 60-69 years (50.3%) and those with lower educational levels (38.8%). Older adults with MM reported better care experiences in primary health care than those without MM (8.70±2.83 vs. 8.42±3.37, p< 0.001). Additionally, household registration in the Family Health Strategy (Brazilian Primary Care model) was associated with better PHC experiences among older adults with MM (9.00±2.68 vs. 8.67±3.06; p< 0.001). In both situations, the attributes with the highest scores were those related to longitudinality, communication and care coordination (p< 0.001).
CONCLUSIONS:
Older adults living with multimorbidity reported more positive primary care experiences, particularly when registered with the Family Health Strategy. Higher scores in longitudinality, communication and care coordination suggest that strengthened and continuous relationships in PHC may play a protective role for this population.
| eISSN: | 2654-1459 |
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