The Cambridge Multimorbidity Score is a new method for measuring multiple long-term health conditions amongst primary care patients, intended to help healthcare planners trying to respond to the needs of patients with multiple health conditions, or multimorbidity. It outperforms the most commonly used current measure, called the Charlson index.
Numbers of patients with multimorbidity are going up as the population ages. The research team who devised the new score explain that consequent pressures on services are exacerbated by policies which promote rapid access over longer consultations and continuity of care, and by single disease guidelines and performance targets which lead to over-prescribing and fail to address the priorities of multimorbid individuals.
Multimorbidity scores offer a means of identifying those patients in the population who are most likely to benefit from a tailored approach to care, helping clinicians to prioritize their efforts accordingly.
The new score is a transparent, simple measure of multimorbidity based on data from UK general practitioner records and weighted on different clinical outcomes, that could be used in future studies of multimorbidity and for resource allocation.
The team, from the Universities of Cambridge and Bristol, with UCL and RAND, looked at 37 comorbidities and important associated outcomes such as general practitioner visits, unplanned hospital admissions and death.
The new score, which includes just 20 conditions, outperforms the widely used Charlson index in predicting all these different outcomes. Performance is best for predicting mortality, particularly following adjustment for age and gender, and least good for predicting primary care consultations.
The Cambridge Multimorbidity Score can be a useful predictor of future health care use, including primary care utilisation, emergency department visits and death and may be of considerable value for policy development and health care priority setting, providing accurate, easy-to-implement ways of optimizing healthcare delivery to an aging population with multiple illnesses,”
– Martin Roland, Emeritus Professor of Health Services Research, Primary Care Unit, University of Cambridge
The research was funded by the National Institute for Health Research School for Primary Care Research, United Kingdom.
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R Payne, S Mendonca, M Elliott, C Saunders, D Edwards, M Marshall, M Roland ‘Development and validation of the Cambridge Multimorbidity Score‘ CMAJ 3 Feb 2020
Lucy Lloyd, Communications, Primary Care Unit