Multimorbidity in a marginalised, street-health Australian population: a retrospective cohort study

OBJECTIVES: Demographic and presentation profile of patients using an innovative mobile outreach clinic compared with mainstream practice. DESIGN: Retrospective cohort study. SETTING: Primary care mobile street health clinic and mainstream practice in Western Australia. PARTICIPANTS: 2587 street health and 4583 mainstream patients. MAIN OUTCOME MEASURES: Prevalence and patterns of chronic diseases in anatomical domains across the entire age spectrum of patients and disease severity burden using Cumulative Illness Rating Scale (CIRS). RESULTS: Multimorbidity (2+ CIRS domains) prevalence was significantly higher in the street health cohort (46.3%, 1199/2587) than age-sex-adjusted mainstream estimate (43.1%, 2000/4583), p=0.011. Multimorbidity prevalence was significantly higher in street health patients(37.7%, 615/1649) compared with age-sex-adjusted mainstream patients (33%, 977/2961), p=0.003 but significantly lower if 65+ years (62%, 114/184 vs 90.7%, 322/355, p CONCLUSIONS: Age-sex-adjusted multimorbidity prevalence and disease severity is higher in the street health cohort. Earlier onset (23-34 years) multimorbidity is found in the street health cohort but prevalence is lower in 65+ years than in mainstream patients. Multimorbidity prevalence is higher for Aboriginal patients of all ages