Association Between the Presence of Multimorbidity and Sociodemographic Factors and Health Care Utilization in the Adult Population of Serbia: A National Health Survey

Introduction: Multimorbidity, defined as the coexistence of two or more chronic conditions in the same person, represents a major challenge for modern health systems due to its association with adverse health outcomes, increased mortality, and high healthcare utilization. We aimed to assess the prevalence of multimorbidity in the adult population of Serbia and examine its association with demographic and socioeconomic factors and healthcare utilization. Methodology: Data were drawn from the 2019 Serbian National Health Survey. Descriptive statistics, chi-square and independent-samples t-tests, as well as univariate and multivariate logistic regression analyses, were performed to examine the associations. Results: The study included 12,439 adults—48.5% men and 51.5% women (mean age: 52.83 ± 17.69). Multimorbidity was present in 35.2% of participants. It was significantly more frequent among women than men (39.65% vs. 30.53%, p < 0.001) and increased markedly with age, reaching 68.63% among individuals aged ≥80 years. Participants with multimorbidity were significantly older than those without it (p < 0.001). Higher prevalence was observed among widowed individuals, participants with lower education, economically inactive persons, those with poorer material status, and residents of Southern and Eastern Serbia (all p < 0.001). Multivariable regression analysis confirmed independent associations between multimorbidity and female sex, older age, lower education, poorer socioeconomic status, and regional disparities. Multimorbidity was a strong predictor of healthcare utilization. Individuals with multimorbidity were significantly more likely to use inpatient and day hospital services, visit specialist physicians, use prescribed medications, and receive home care (all p < 0.05). Conclusion: Multimorbidity affects more than one-third of adults in Serbia and is strongly associated with demographic and socioeconomic disadvantage. It substantially increases healthcare utilization, underscoring the need for integrated, patient-centered care and targeted public health interventions.