Exploring the Linkages Between Non-Communicable Disease Multimorbidity, Health Care Utilization and Expenditure Among Aboriginal Older Adult Population in India

Abstract

Objective: The study investigates the magnitude and correlates of non-communicable disease multimorbidity and explores its linkages with health care utilization and out-of-pocket expenditure among aboriginal or tribal older adults.Methods: The study employed data on 11,365 older adults from Scheduled Tribes from the Longitudinal Ageing Study in India, 2017-18. A disease score was computed integrating sixteen non-communicable diseases. Descriptive, bivariate, and multivariable analyses were performed to identify the magnitude and correlates of multimorbidity. The study further explored the linkages between selected diseases and multimorbidity with health care utilization and expenditure.Results: The findings suggest that 27.1 and 14.5% of the aboriginal population lived with single or multiple disease, respectively. Hypertension and gastrointestinal disorders were frequent diseases. Higher age, Muslim religion, higher education, unemployment, and affluent background were the major correlates of multimorbidity. Health care utilization, mean expenditure on hospitalization, and outpatient visits increased significantly with multimorbidity.Conclusion: Multimorbidity is emerging as a health care challenge among the aboriginal population. Measures need to be taken to assess the multimorbidity burden and reduce health care expenditure, ensuring health equity among country’s vulnerable population.