Impact of Multi-Morbidity Patterns on Length of Hospitalization and Mortality: A Study of Elderly General Clinic Patients at a Hospital in Ghana

Abstract

In this paper, we identify multimorbidity patterns among elderly patients and determine their im-pact on length of hospitalization (LOH) until death and on mortality. The study utilized a sample of 984 elderly general clinic patients aged 50 years or older extracted from clinical data main-tained at the Kwadaso S.D.A hospital in Ghana. Multimorbidity patterns were identified by ex-ploratory tetrachoric factor analysis using a threshold of 0.5 in absolute value. To determine their impact on the LOH until death and on mortality, accelerated failure time (AFT) models, specifi-cally the exponential and Weibull models were employed. Three multimorbidity patterns were iden-tified: cardio-metabolic and pain disorders (CMPD), cardio-pulmonary disorders (CPD), and gas-trointestinal, low back pain and anxiety disorders (GLAD). However, the Weibull model (AIC=239.7) provided a better fit when compared to the exponential model (AIC=259.3). Hence, results from the Weibull model revealed that the median LOH until death for patients with CMPD compared to those with GLAD was decreased by a factor of 0.46. Similarly, among patients with CPD compared to those with GLAD their median LOH until death was decreased by a factor of 0.45. Additionally, the estimated median LOH until death were approximately 16 days for patients with CMPD and patients with CPD, and 35 days for those with GLAD. Hospitalized elderly pa-tients with these multimorbidity patterns, especially those with CPD and patients with CMPD were vulnerable to increasing likelihood of mortality.