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

Abstract

Background: The 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.

Objectives This 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.

Methods: A 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.

Results: A 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.

Conclusions The 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.

Keywords

Township health centers / Multimorbidity / Number of co-existing chronic conditions / Multimorbidity pattern / Inpatient care utilization / Associated factors

Declarations

Not applicable.

Authors' contributions

Conceptualization, S.Y.; Methodology, S.Y.; Data curation, X.Q., J.S., P.H. Q.J., W.X. and Z.Y.; Formal analysis, S.Y., X.Q., Z.C. and Z.Y.; Funding acquisition, not applicable; Project administration, not applicable; Resources, not applicable; Supervision, S.Y.; Validation, S.Y.;

Writing—original draft, X.Q.; Writing—review and editing, S.Y. All authors have read and agreed to the published version of the manuscript.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

This research was supported by grants from National Natural Science Foundation of China (72364004; 71864006) , CVANGJSIH BOUXCUENGH SWCIGIH GOUYQZ GISUZ DINGH (2020GXNSFAA238019), Guangxi Medical University (2023Y74) and Guangxi Humanities and Social Sciences Key Research Base for Health and Economic and Social Development (2024RWB08).

Authors' other information

Not applicable.

Competing interests

Not applicable.

Acknowledgements

Not applicable.

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