Multimorbidity in a large district hospital: A descriptive cross-sectional study

Area of Science:

• Internal Medicine
• Public Health
• Epidemiology

Background:

• Limited research exists on disease profiles within South African hospital settings, despite extensive data on primary care.
• Understanding hospital disease burdens is crucial for effective healthcare planning and resource allocation.

Purpose of the Study:

• To characterize the disease profile in a district hospital's internal medicine department.
• To analyze the impact of comorbidities, including the HIV/tuberculosis (TB) syndemic, on patient length of stay.
• To investigate the role of HIV acuity and lifestyle risk factors.

Main Methods:

• Retrospective review of all consecutive admissions to internal medicine at a large district hospital in the Cape metropole during May 2015.
• Data analysis focused on prevalent diseases, multimorbidity, and factors influencing length of stay.

Main Results:

• Hypertension, HIV, type 2 diabetes mellitus, TB, and cardiac failure were the most common diagnoses.
• 86% of patients had at least two comorbidities, with an average of 3.4 per patient.
• HIV/TB co-infection and defaulting from antiretroviral treatment were associated with longer hospital stays.

Conclusions:

• Chronic conditions, particularly HIV, TB, and non-communicable diseases, dominate the internal medicine disease profile.
• HIV/TB co-infection significantly prolongs length of stay, underscoring the need for integrated management.
• Addressing multimorbidity requires enhanced medical education and health system reforms, emphasizing patient perspectives and community partnerships.