Perspectives, Constructs And Methods In The Measurement Of Multimorbidity And Comorbidity: A Critical Review

Background: There is no question about the importance of measuring multimorbidity and comorbidity. However, reviews of measures of multimorbidity/comorbidity are limited to multimorbidity indices that are used to predict mortality, disability, healthrelated quality of life and healthcare costs at individual level. Objective: To describe the perspectives, constructs and methods used in the measurement of multimorbidity and comorbidity. Methods: A structured literature search for studies reporting the measurement of multimorbidity or comorbidity was conducted in Medline and Embase. The references of the identified papers were consulted without restriction. The methods used by other researches that have reported on multimorbidity and comorbidity were also reviewed. The findings of the review are summarized under major constructs of multimorbidity and comorbidity. Results: Multimorbidity/comorbidity measurements involve the consideration of several perspectives. The four major constructs of multimorbidity/comorbidity measurement are magnitude, severity, pattern and burden. There are two major approaches of measuring multimorbidity and comorbidity. The first approach reduces measurements of multiple diseases to a single condition and the second approach uses clustering of diseases and cases in to relevant non-random groups. Conclusion: The measurement of multimorbidity involves multiple perspectives, constructs and methods.