title: Quality of care measures in multimorbidity.
abstract: BACKGROUND
  Multimorbidity is increasingly prevalent in general practice, creating challenges for assessment and management. This paper aims to explore the methods used to assess the quality of care for primary care patients with multimorbidity.
  
  
  METHODS
  A systematic review of the published literature was conducted using major medical databases (Medline, Scopus, Embase and CINAHL). Measures were then categorised using the Donabedian framework.
  
  
  RESULTS
  Twenty-seven studies were included. All of the process measures were disease-specific. Some non-disease-specific measures of outcome were identified, including functional outcomes, healthcare utilisation and patient-rated measures.
  
  
  CONCLUSIONS
  There has been a reliance on measures of process and outcome for single conditions in the assessment of quality of care. A broader, more comprehensive range of measures of structure, process and outcome is needed to fully evaluate the care of patients with multimorbidity.
authors.affiliation: medical student, Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales.
authors.forename: Megan
authors.initials: M
authors.lastname: Pillay
authors.forename: Sarah
authors.initials: S
authors.lastname: Dennis
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
mesh_terms: D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D006300:Health Services Misuse; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D015995:Prevalence; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care