Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana
Biostatistics Department, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.
BMJ Open Respir Res. 2021 Nov;8(1). doi: 10.1136/bmjresp-2021-001034.
Data on asthma hospitalisations are a useful source of patient morbidity information. In Ghana, the length of stay (LoS) and sociodemographic factors of patients hospitalised for asthma and its exacerbation are understudied. We aimed to investigate the time to discharge and assessed factors associated with length of hospital stays of asthmatics in Ghana.
Retrospective analysis of hospitalised patient with asthma records between 2012 and 2017 from the nationwide Ghana Health Service District Health Information Management System 2 database. We calculated the cumulative incidence function for discharge stratified by age group and sex. Multivariable Cox regression was used to investigate the association of sociodemographic characteristics with the LoS.
Of 19 926 asthma-associated hospitalisations, 730 (3.7%) were due to asthma exacerbation. Overall mean age was 34 years (SD=24.6), in 12 000 (60.2%) hospitalisations, patients were female. There were 224 deaths (1.1%). Median LoS was 2 days (IQR: 1-3) with almost 90% of all patients discharged by the seventh day. Age and region were among the covariates showing significant association with LoS. Age below 10 years (HR: 1.39 (1.11 to 1.78)) was associated with early discharge while comorbidity and health insurance ownership were associated with late discharge (p<0.001). LoS did not vary by sex. Compared with the Greater Accra region, patients in other regions had shorter LoS, especially the Ashanti and Upper West regions (p<0.001). LoS increased annually, but was highest in 2016 (HR: 0.94 (0.90 to 0.98)).
Disparities in LoS across regions, and an overall increasing annual trend in Ghana call for tailored healthcare resource allocation. Longer LoS implies that patients are often absent from school or work leading to substantial financial and emotional costs to individuals and families.
哮喘住院数据是了解患者发病情况的有用信息来源。在加纳，哮喘住院患者的住院时间（LoS）和社会人口学因素尚未得到充分研究。我们旨在调查出院时间，并评估与加纳哮喘住院患者住院时间相关的因素。
对 2012 年至 2017 年期间全国加纳卫生服务地区卫生信息管理系统 2 数据库中哮喘住院患者记录进行回顾性分析。我们按年龄组和性别对出院情况进行累积发病率函数计算。使用多变量 Cox 回归分析社会人口学特征与 LoS 的相关性。
在 19926 例哮喘相关住院中，730 例（3.7%）是由于哮喘恶化。总体平均年龄为 34 岁（SD=24.6），在 12000 例（60.2%）住院中，患者为女性。有 224 例死亡（1.1%）。中位 LoS 为 2 天（IQR：1-3），几乎 90%的患者在第 7 天前出院。年龄和地区是与 LoS 有显著相关性的协变量之一。年龄低于 10 岁（HR：1.39（1.11 至 1.78））与提前出院相关，而合并症和医疗保险的拥有与延迟出院相关（p<0.001）。LoS 与性别无关。与大阿克拉地区相比，其他地区的患者 LoS 更短，特别是阿散蒂和上西部（p<0.001）。LoS 每年都在增加，但在 2016 年最高（HR：0.94（0.90 至 0.98））。
加纳各地的 LoS 差异以及整体逐年增加的趋势需要定制医疗资源分配。较长的 LoS 意味着患者经常缺课或缺勤，给个人和家庭带来巨大的经济和情感成本。
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