Project Details

Project Overview

Life expectancy has increased globally, contributing to the rising prevalence of multimorbidity—defined as the coexistence of two or more chronic conditions in an individual. Multimorbidity poses significant challenges to low- and middle-income countries (LMICs), such as India, where healthcare is largely financed out-of-pocket. Despite evidence of high multimorbidity prevalence, there is limited understanding of its economic burden at the subnational level.

The Economic Well-being of the Bangalore Elderly (EMBiBE) study aims to estimate healthcare utilisation, direct and indirect costs, and the economic consequences of multimorbidity among older adults in urban Bangalore. The study will assess out-of-pocket expenditure (OOPE), catastrophic health expenditure (CHE), hardship financing, and impoverishment, along with associated factors influencing these outcomes. The EMBiBE study employs a mixed-methods design integrating a cross-sectional household survey and semi-structured interviews among adults aged 60 years and above.

Eighty wards across urban and peri-urban Bangalore will be selected using probability-proportional-to-size sampling. Data collection will include socio-demographic characteristics, 37 chronic disease conditions, healthcare utilisation, and expenditure. Standard tools such as EQ-5D (for health-related quality of life) and MMAS-8 (for medication adherence) will be used. Quantitative data will be analysed using descriptive statistics, bivariate analyses, and multivariable regression models, including generalised linear models, to explore associations among multimorbidity, costs, and financial outcomes. Qualitative data will be analysed thematically using the framework approach to capture lived experiences and coping strategies.