Urban–rural and socioeconomic status: Impact on multimorbidity prevalence in hospitalized patients

Lynn Robertson* (Corresponding Author), Dolapo Ayansina, Marjorie Johnston, Angharad Marks, Corri Black

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Downloads (Pure)


Objective:The aim of this study was to describe multimorbidity prevalence in hospitalized adults, by urban?rural area of residence and socioeconomic status (SES).Methods:Linked hospital episode data were used. Adults (≥18 years) admitted to hospital as an inpatient during 2014 in Grampian, Scotland, were included. Conditions were identified from admissions during the 5 years prior to the first admission in 2014. Multimorbidity was defined as ≥2 conditions and measured using Tonelli et al. based on International Classification of Diseases-10 coding (preselected list of 30 conditions). We used proportions and 95% confidence intervals (CIs) to summarize the prevalence of multimorbidity by age group, sex, urban?rural category and deprivation. The association between multimorbidity and patient characteristics was assessed using the ? 2 test.Results:Forty one thousand five hundred and forty-five patients were included (median age 62, 52.6% female). Overall, 27.4% (95% CI 27.0, 27.8) of patients were multimorbid. Multimorbidity prevalence was 28.8% (95% CI 28.1, 29.5) in large urban versus 22.0% (95% CI 20.9, 23.3) in remote rural areas and 28.7% (95% CI 27.2, 30.3) in the most deprived versus 26.0% (95% CI 25.2, 26.9) in the least deprived areas. This effect was consistent in all age groups, but not statistically significant in the age group 18?29 years. Multimorbidity increased with age but was similar for males and females.Conclusion:Given the scarcity of research into the effect of urban?rural area and SES on multimorbidity prevalence among hospitalized patients, these findings should inform future research into new models of care, including the consideration of urban?rural area and SES.
Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalJournal of Comorbidity
Early online date20 Apr 2020
Publication statusPublished - 2020

Bibliographical note

The author(s) disclosed receipt of the following financial support
for the research, authorship, and/or publication of this article: This
work was funded by NHS Grampian, Public Health Directorate.
This work was also supported by Health Data Research UK which
receives its funding from HDR UK Ltd (HDR-5012) funded by
the UK Medical Research Council, Engineering and Physical
Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care
Directorates, Health and Social Care Research and Development
Division (Welsh Government), Public Health Agency (Northern
Ireland), British Heart Foundation (BHF) and the Wellcome

Data accessibility statement
De-identified data used for this study are held by Grampian Data
Safe Haven. These data are available provided the necessary permissions have been obtained. Further information is available at
php and requests for data may be made to Professor Corri Black
on behalf of Grampian Data Safe Haven, corri.black@abdn.ac.uk.


  • hospitalization
  • multimorbidity
  • prevalance
  • socioeconomic status
  • urban–rural
  • electronic health records


Dive into the research topics of 'Urban–rural and socioeconomic status: Impact on multimorbidity prevalence in hospitalized patients'. Together they form a unique fingerprint.

Cite this