A study on multimorbidity patterns, Inpatient care utilization, and associated factors in inpatients with Multimorbidity in township health centers of Guangxi

Abstract

Listen

Translate article

BackgroundThe epidemiology of multimorbidity, inpatient care utilization, and associated factors among inpatients in rural primary health care facilities in China remains unclear, hindering effective prevention and management of multimorbidity in rural populations. ObjectivesThis study aims to investigate the patterns of multimorbidity, inpatient care utilization, and related factors among hospitalized patients in township health centers (rural primary healthcare facilities) in Guangxi, China. MethodsA multistage stratified and cluster random sampling method was employed to select 10 township health centers (rural primary healthcare facilities) in Nanning, Wuzhou, Liuzhou, Yulin, and Guigang of Guangxi Autonomous Region of China. De-identified inpatient medical records from January 1, 2021, to June 30, 2023, were retrieved from inpatient and chronic disease management systems. Statistical analyses, including the Kruskal-Wallis H test, Mann-Whitney U test, and multinomial logistic regression, were used to explore the demographic characteristics, multimorbidity prevalence, comorbidity number, multimorbidity patterns, hospitalization frequency, and associated factors among inpatients with multimorbidity. ResultsA total of 9,330 patients with multimorbidity were included, with an average age of 68.1 ±11.8 years, and 52.6 % were female. The overall prevalence of multimorbidity was 31.24 %. The most prevalent comorbidity number was 2 (53.22 %), followed by 3 (28.76 %), 4 (12.92 %), and ≥5(5.1 %). Hypertension was the most prevalent co-existing chronic condition, and the most common multimorbidity patterns included combinations of hypertension, chronic cervical and lumbar spondylosis, chronic gastrointestinal diseases, stroke, diabetes mellitus, hyperlipidemia, and chronic pulmonary diseases. The median number of hospitalization frequency for the top 10 multimorbidity patterns ranged from 1 to 4.5, with significant differences in hospitalization frequency across multimorbidity groups. Age, BMI, gender, smoking, alcohol consumption, ethnicity, marital status, and medical insurance were significantly associated with number of co-existing chronic conditions, while age, gender, smoking, alcohol consumption, ethnicity, marital status, education level, medical insurance, and number of co-existing chronic conditions were significantly associated with hospitalization frequency. ConclusionsThe prevalence of multimorbidity among inpatients in township health centers(rural primary healthcare facilities) in Guangxi is high. Hypertension was the most prevalent co-existing condition, with frequent combinations involving chronic cervical and lumbar spondylosis, gastrointestinal diseases, stroke, diabetes, hyperlipidemia, and chronic pulmonary diseases. Multiple factors influence both number of co-exsiting chronic conditions and hospitalization frequency, emphasizing the need for comprehensive, multifaceted strategies to manage the challenges of multimorbidity in rural primary healthcare facilities.