Unmet needs and satisfaction with healthcare in patients with multimorbidity

Abstract Background Health outcomes of patients with multimorbidity are associated with the satisfaction with the care received. The objective of this study is to describe and compare the needs, adequacy of and satisfaction with the received healthcare in patients with complex chronic diseases in Spain. Methods Data from a convenience sample of patients participating in the Access to Diagnosis and Treatment and Healthcare Survey (Spanish Patient Organizations Platform, 2022). The chronic conditions were grouped into osteoarticular, cardiovascular, neurological, respiratory, diabetes, rare diseases, digestive, vision diseases, cancer and others. The main variables included were satisfaction with the received care (0-10), perceived adequacy of care (1-5) and unmet needs (yes/no). Bivariate analyses (chi-squared and Mann-Whitney tests and correlation coefficients) were performed. Results 1133 patients answered the survey: mean age 49.5 years (standard deviation, SD: 14.8), 55.1% women, mean of 2.9 chronic health conditions (SD: 1.7). Participants showed higher levels of satisfaction with routine follow-ups and control of diseases than with access to rehabilitation and specialized care. Satisfaction with healthcare was associated with perceived adequacy of follow-ups (r= -0.79, p < 0.01). Patients with osteoarticular pathologies reported a higher number of unmet needs (57%), rated the care received as less adequate (mean 3.4; SD: 0.9) and less satisfactory (mean 4.2; SD: 2.8). Patients with cancer reported fewer unmet needs (6%), considered the care adequate (mean 2.9; SD: 0.9) and satisfactory (mean 6.8; SD: 3.1). Similar figures were also seen in patients with cardiovascular diseases. Conclusions Knowledge on patients’ perceived unmet needs and demands may lead to improving satisfaction with the health system. Comprehensive care for people with multimorbidity, including assessing patients’ perception, is a challenge that must be addressed by healthcare systems. Key messages • The analysis of the differences between pathologies in their demands will better describe the reality of patients with multimorbidity in Spain. • The perception of healthcare adequacy and satisfaction greatly varies across the type of chronic condition.