Multimorbidity and delivery of care for long-term conditions in the English National Health Service: baseline data from a cohort study

Peter Bower, Mark Hann, Jo Rick, Kelly Rowe, Jenni Burt, Martin Roland, Joanne Protheroe, Gerry Richardson, David Reeves

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: Many patients with long-term conditions have multiple conditions. Current delivery of care is not designed around their needs and they may face barriers to effective self-management. This study assessed the relationships between multimorbidity, the delivery of care, and self-management.

METHODS: We surveyed 2439 patients with long-term conditions concerning their experience of the delivery of care and self-management in England in 2011. We assessed multimorbidity in terms of a count of long-term conditions and the presence of 'probable depression'. We explored the relationships between multimorbidity, patient experience of the delivery of care, and self-management

RESULTS: Neither measure of multimorbidity was a significant predictor of patients' experience of the delivery of care. Patients with multimorbidity reported higher levels of self-management behaviour, while the presence of depression was associated with less positive attitudes towards self-management.

CONCLUSIONS: The current data do not demonstrate a consistent impact of multimorbidity on patients' experience of care or on self-management. Further research is required to assess those types of multimorbidity that are associated with significant deficits, or to identify other aspects of care that might be problematic in the context of multiple conditions.

Original languageEnglish
Pages (from-to)29-37
Number of pages9
JournalJournal of Health Services Research & Policy
Issue number2 Suppl
Publication statusPublished - Oct 2013


  • Adolescent
  • Adult
  • Aged
  • Chronic Disease
  • Comorbidity
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Depression
  • England
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Quality of Health Care
  • Questionnaires
  • Self Care
  • State Medicine

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