J Valderas|Bárbara Starfield|Bonnie Sibbald|Chris Salisbury|Martín Roland
Defining Comorbidity: Implications for Understanding Health and Health Services
National Institute for Health Research|University of Manchester|Johns Hopkins University|National Institute for Health Research|University of Manchester|University of Manchester|NIHR Manchester Biomedical Research Centre|National Institute for Health Research|University of Bristol
comorbidity associated worse health outcomes complex clinical management increased health care coststhere agreement however meaning term related constructs multimorbidity morbidity burden patient complexity well conceptualizedin article review defi nitions comorbidity relationship related constructswe show value given construct lies ability explain particular phenomenon interest within domains 1 clinical care 2 epidemiology 3 health services planning fi nancingmechanisms may underlie coexistence 2 conditions patient direct causation associated risk factors heterogeneity independence examined implications clinical care consideredwe conclude precise use constructs proposed article would lead improved research phenomenon ill health clinical care epidemiology health services