Key result
Female sex was associated with earlier hospital discharge (HR 1.09), whereas having a surgical procedure (HR 0.77) or comorbidities like diabetes (HR 0.76) prolonged the length of stay.
Why the study?
Hospitalisation for hypertension continues to rise in Ghana, with patients spending between 1 and 91 days on admission, but the factors influencing hospitalisation duration were not well characterized.
What individual and health-related factors influence the hospital length of stay for hypertensive inpatients in Ghana?
Cohort (n=106,372)
Yes
What individual and health-related factors influence the hospital length of stay for hypertensive inpatients in Ghana?
Most hospitalizations for hypertension in Ghana are brief (median 3 days), though length of stay is significantly prolonged in patients with concurrent comorbidities or those requiring surgical interventions.
May inform discharge planning in Ghanaian hypertensive care; leaves open causality and generalizability beyond this cohort.
OBJECTIVE: Hospitalisation for hypertension continues to rise in Ghana. It has been revealed that in Ghana, patients hospitalised for hypertension spend between 1 and 91 days on admission. This study therefore sought to estimate the hospital length of stay (LoS) of hypertensive patients and individual or health-related factors that may influence the hospitalisation duration in Ghana. METHODS: We employed a retrospective study design that used routinely collected health data on hospitalised hypertensive patients in Ghana from the District Health Information Management System database between 2012 and 2017 to model LoS using survival analysis. The cumulative incidence function for discharge stratified by sex was computed. To investigate the factors that influence hospitalisation duration, multivariable Cox regression was used. RESULTS: Out of a total of 106 372 hypertension admissions, about 72 581 (68.2%) were women. The mean age of the patients was 55.3 (SD=17.5) years. Overall, the median LoS was 3 days with almost 90% of all patients being discharged by the 10th day of admission. Patients admitted in Volta region (HR: 0.89, p<0.001) and Eastern region (HR: 0.96, p=0.002) experienced late discharge as compared with patients admitted in Greater Accra. It was revealed that women (HR: 1.09, p<0.001) were discharged earlier than men. However, having a surgical procedure (HR: 1.07, p<0.001) and having comorbidities such as diabetes (HR: 0.76, p<0.001) and cardiovascular diseases other than hypertension (HR: 0.77, p<0.001) increased the LoS of patients. CONCLUSION: This study provides the first comprehensive assessment of factors influencing hospitalisation duration of admissions due to hypertension in Ghana. Female sex, all regions except Volta region and Eastern region, experienced early discharge. However, patients with a surgical intervention and comorbidity experienced late discharge.
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Afetor et al. (2023) conducted a cohort in Hypertension (n=106,372). Female sex vs. Male sex was evaluated on Hospital length of stay (time to discharge alive) (HR 1.09, 95% CI 1.07-1.10, p=<0.001). Female sex was associated with earlier hospital discharge (HR 1.09), whereas having a surgical procedure (HR 0.77) or comorbidities like diabetes (HR 0.76) prolonged the length of stay.
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