The impact of cardiovascular multimorbidity on healthcare service utilisation under three primary care organisational models in China

Purpose China’s current healthcare reform leads to the emergence of community health centres (CHCs) of different models for delivering primary care services especially for patients with chronic conditions. Cardiovascular multimorbidity is a frequent phenomenon among such patients, yet less is known on its impact on healthcare service utilization in the primary care setting. This study aimed to compare the healthcare utilization patterns with cardiovascular multimorbidity under different CHC organisational models in China. Methods Cardiovascular multimorbidity was defined as the presence of two or more medical conditions related to cardiovascular diseases. Data on patients with cardiovascular multimorbidity who had a regularly attended CHC were extracted from a previous multicentre study in Guangdong province in southern China. Healthcare service utilization was measured in terms of primary care consultations in the previous 6 months, and a 4-point liker-type scale was developed to measure the continuity of care. Analysis of covariance was performed after Bonferroni-corrected adjustments were made for covariates. Results A total number of 383 primary care patients fulfilled all the inclusion criteria and the average number of cardiovascular diseases is 2.22 (95% CI: 2.18–2.27). Multiple linear regression analysis showed that healthcare service utilization was significantly increased among patients with cardiovascular multimorbidity (2.10; 95% CI: 0.73–3.47, p=0.003). After adjustment weremade for age and gender, patients of government-owned CHCs exhibited superior scores in the continuity of care (13.83; 95% CI: 13.51–14.14), compared to patients of privately-owned CHCs (12.93; 95% CI: 12.66–13.20, p Conclusion The study suggested government-owned primary care providers might perform better continuous primary care services for patients with cardiovascular multimorbidity. Further in-depth understanding of the impact of cardiovascular multimorbidity and multimortality is needed to inform the way in which primary care providers are performed to correspond to the challenge from cardiovascular multimorbidity.