Back
 OJEpi  Vol.7 No.4 , November 2017
Spectrum of Diseases, Disease Related Mortality and Overall Financial Burden of Hospitalized Patients in Medical Wards of Tertiary Care Public Hospital
Abstract: Background: Detailed assessment of pattern of diseases and trend of mortalities tends to aid in formulating pivotal aspects of in-hospital policies, standards of care and so consequently promoting efficient work system. This also reserves limited resources keeping within the limit of financial grasp. The study aims to reimburse the colossal paucity of data covering epidemiological burden of diseases, impact on mortality as well as financial burden in socioeconomically challenged public health system. Methods: This was a retrospective cross-sectional hospital based study conducted in department of Medicine, Civil Hospital Karachi, from February 2016 to July 2016 using questionnaire based data collection system. Results: Eight thousand and fifty three (8053) cases with almost equal gender proportion were analyzed. Chronic liver disease (CLD) was the most rampant disease, followed by cerebrovascular accident (CVA), tuberculosis and diabetes. Overall 51% cases were attributed to infectious diseases. Overall the average percentage mortality was found to be 20% of all cases. Mean duration of stay was 7.56 ± 7 days. Estimated average total in-hospital expenditure per patient on each visit or stay was 159.15 ± 41.2 $USD (16670.96 ± 4315.7 PKR). Average total diagnostic and medications costs per visit or stay were 89.74 ± 31.2 $USD (9400.26 ± 3268.2 PKR) and 48.68 ± 18.0 $USD (5099.23 ± 1885.5 PKR) respectively. Conclusion: Chronic liver disease, cerebrovascular accident and diabetes were most frequent reasons of hospital admission and mortality. Recognition of most common and fatal diseases with their expenditure is going to lead to formulation of targeted policies both of which would be effective and efficient.
Cite this paper: Naqvi, I. , Mahmood, K. , Talib, A. , Kashif, S. and Sajjad, A. (2017) Spectrum of Diseases, Disease Related Mortality and Overall Financial Burden of Hospitalized Patients in Medical Wards of Tertiary Care Public Hospital. Open Journal of Epidemiology, 7, 337-348. doi: 10.4236/ojepi.2017.74028.
References

[1]   Pan, J.C. and Cheung, T.D. (1982) Medical and Cardio Vascular Diseases, Admission in Hong Kong Hospital. Bulletin Hong Kong Medical Association, 34, 55-62.

[2]   Respiratory Diseases in Canada (2001) Canadian Institute for Health Information. Canadian Lung Association. Health Canada. Statics Canada, Ottawa, Canada, 1-102.

[3]   Gaziano, T.A., Bitton, A., Anand, S. Abrahams-Gessel, S. and Murphy, A. (2010) Growing Epidemic of Coronary Heart Disease in Low- and Middle-Income Countries. Current Problems in Cardiology, 35, 72-115.

[4]   Bygbjerg, I.C. (2012) Double Burden of Non Communicable and Infectious Diseases in Developing Countries. Science, 337, 1499-501.
https://doi.org/10.1126/science.1223466

[5]   Iezzoni, L.I. (2013) Reasons for Risk Adjustment. In: Risk Adjustment for Measuring Health Care Outcomes, Health Administration Press, Illinois, Chicago, 1-14.

[6]   Singhi, S., Gupta, G. and Jain, V. (2004) Comparison of Pediatric Emergency Patients in a Tertiary Care Hospital vs. a Community Hospital. Indian Pediatrics, 41, 67-72.

[7]   United Nations Development Program (2007) Human Development Report 2007/2008. Fighting Climate Change: Human Solidarity in a Divided World. UNDP, New York, 239.

[8]   World Health Organization (2000) World Health Report 2000. Health Systems: Improving Performance. WHO, Geneva, 73-90.

[9]   World Health Organization (2016) WHO Country Fact Sheet. World Health Organization, Geneva. Available from
http://www.who.int/countries/pak/en/. Accessed: Oct 2016.

[10]   Marsh, D.R., Kadir, M.M., Husein, K., Luby, S.P., Siddique, R. and Khalid, S.B. (2000) Adult Mortality in Slums of Karachi, Pakistan. Journal of the Pakistan Medical Association, 50, 300-306.

[11]   Bhurgi, A., Bhurgi, Y., Khan, Y., Sharih, U., Naqvi, F. and Soomro, I.B. (2001) Mortality Statistics in South Karachi. Journal of the Pakistan Medical Association, 51, 446-449.

[12]   Centers for Disease Control and Prevention. Menu of Suggested Provisions for State Tuberculosis Prevention and Control Laws: Definitions for Consideration.

[13]   World Health Organization. Noncommunicable Diseases: Fact Sheet.
http://www.who.int/mediacentre/factsheets/fs355/en/

[14]   Pokharel, B.R., Humagain, S., Pant, P., Gurung, R., Koju, R. and Bedi, T.R. (2012) Spectrum of Diseases in a Medical Ward of a Teaching Hospital in a Developing Country. Journal of College of Medical Sciences-Nepal, 12, 7-11.

[15]   Haitham, M., Bingawi, E.I., Hussein, M., Mohamed, B. and Bakheet, Y. (2014) Characteristics of Patients Admitted to Medical Ward of a Referral Hospital in a Developing Country. International Journal of Sciences: Basic and Applied Research, 14, 86-92.

[16]   Ali, E. and Woldie, M. (2010) Reasons and Outcomes of Admissions to the Medical Wards of Jimma University Specialized Hospital, Southwest Ethiopia. Ethiopian Journal of Health Sciences, 20, 113-120.

[17]   Ashraf, M. and Zakria, M. (2014) Disease Patterns: Admitted Patients in Medical Ward of Independent University Hospital, Marzipura, Faisalabad. Professional Medical Journal, 21, 570-574.

[18]   Alamoudi, O.S., Attar, S.M., Ghabrah, T.M. and Al-Qassimi, M.A. (2009) Pattern of Common Diseases in Hospitalized Patients at an University Hospital in Saudi Arabia; A Study of 5594 Patients. Medical Science, 16.
https://doi.org/10.4197/Med.16-4.1

[19]   Ogunmola, O.J. and Oladosu, O.Y. (2014) Pattern and Outcome of Admissions in the Medical Wards of a Tertiary Health Center in a Rural Community of Ekiti State, Nigeria. Annals of African Medicine, 1, 195.
https://doi.org/10.4103/1596-3519.142291

[20]   E.G. (1960) Saint Medical Morbidity in a General Hospital. Medical Journal of Australia, 2, 601-608.

[21]   Adeoti, A.O., Ajayi, E.A., Ajayi, A.O., Dada, S.A., Fadare, J.O., Akolawole, M., Adekeye, K.A. and Raimi, T.H. (2015) Pattern and Outcome of Medical Admissions in Ekiti State University Teaching Hospital, Ado-Ekiti-a 5 Year Review. American Journal of Medicine and Medical Sciences, 5, 92-98.

[22]   Aziz, S., Ejaz, A. and Alam, S.E. (2013) Mortality Pattern in a Trust Hospital: A Hospital Based Study in Karachi. Journal of the Pakistan Medical Association, 63, 1031-1035.

[23]   Tariq, M., Jafri, W., Ansari, T., Awan, S., Ali, F., Shah, M., Jamil, S., Riaz, M. and Shafqat, S. (2009) Medical Mortality in Pakistan: Experience at a Tertiary Care Hospital. Postgraduate Medical Journal, 85, 470-474.
https://doi.org/10.1136/pgmj.2008.074898

[24]   Rao, M.H. and Soomro, I.B. (2001) Disease Pattern, Seasonal Variation and Major Causes of Death in Indoor Patients at Medical Units of Civil Hospital, Karachi. PJMR, 40, 56-60.

[25]   Qadir, A., Nadeem, M.A., Munir, A. and Khan, Z.U. (2016) An Audit of Indoor Morbidity and Mortality in a Medical Ward at a Tertiary Care Hospital. Annals of King Edward Medical University, 11.

[26]   Memon, A.R., Hussain, T. and Asfar, S. (2005) Mortality Rate in a General Medical Unit. Med Channel, 11, 49-51.

[27]   (2002) Annual Health Bulletin. Department of Health Services, Sri Lanka, 22-31.
http://www.heath.gov.Ik/tsumami/Links/ahb2002.html

[28]   Papadopoulos, I.N., Papaefthymiou, M., Roumeliotis, L., Panagopoulos, V.G., Stefanidou, A. and Kostaki, A. (2008) Status and Perspectives of Hospital Mortality in a Public Urban Hellenic Hospital, Based on a Five-Year Review. BMC Public Health, 23, 28.
https://doi.org/10.1186/1471-2458-8-28

[29]   Sans, S., Kesteloot, H. and Kromhout, D.O. (1997) The Burden of Cardiovascular Diseases Mortality in Europe. European Heart Journal, 18, 1231-1248.
https://doi.org/10.1093/oxfordjournals.eurheartj.a015434

[30]   Shelat, P.R. and Kumbar, S.K. (2015) A Retrospective Analysis of Direct Medical Cost and Cost of Drug Therapy in Hospitalized Patients at Private Hospital in Western India. Journal of Clinical and Diagnostic Research: JCDR, 9, FC09.
https://doi.org/10.7860/JCDR/2015/15121.6724

[31]   Norris, C., Jacobs, P., Rapoport, J. and Hamilton, S. (1995) ICU and Non-ICU Cost per Day. Canadian Journal of Anesthesia, 42, 192-196.
https://doi.org/10.1007/BF03010674

[32]   Patel, M.K., Barvaliya, M.J., Patel, T.K. and Tripathi, C. (2013) Drug Utilization Pattern in Critical Care Unit in a Tertiary Care Teaching Hospital in India. International Journal of Critical Illness and Injury Science, 3, 250-255.
https://doi.org/10.4103/2229-5151.124128

[33]   Shankar, P.R., Upadhyay, D.K., Subish, P., Bhandari, R.B. and Das, B. (2010) Drug Utilization among Older Inpatients in a Teaching Hospital in Western Nepal. Singapore Medical Journal, 5, 28-34.

 
 
Top