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Interaction of mental comorbidity and physical multimorbidity predicts length-of-stay in medical inpatients

Background: Mental comorbidities of physically ill patients lead to higher morbidity, mortality, health-care utilization and costs. Objective: The aim of the study was to investigate the impact of mental comorbidity and physical multimorbidity on the length-of-stay in medical inpatients at a maximum...

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Main Authors: Stahl-Toyota, Sophia (Author) , Nikendei, Christoph (Author) , Nagy, Ede (Author) , Bönsel, Stefan (Author) , Dönnhoff, Ivo (Author) , Unger, Inga (Author) , Szendrödi, Julia (Author) , Frey, Norbert (Author) , Michl, Patrick (Author) , Müller-Tidow, Carsten (Author) , Jäger, Dirk (Author) , Friederich, Hans-Christoph (Author) , Hochlehnert, Achim (Author)
Format: Article (Journal)
Language:English
Published: 2023
In: PLOS ONE
Year: 2023, Volume: 18, Issue: 6, Pages: 1-16
ISSN:1932-6203
DOI:10.1371/journal.pone.0287234
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1371/journal.pone.0287234
Verlag, kostenfrei, Volltext: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287234
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Author Notes:Sophia Stahl-Toyota, Christoph Nikendei, Ede Nagy, Stefan Bönsel, Ivo Rollmann, Inga Unger, Julia Szendrödi, Norbert Frey, Patrick Michl, Carsten Müller-Tidow, Dirk Jäger, Hans-Christoph Friederich, Achim Hochlehnert
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Summary:Background: Mental comorbidities of physically ill patients lead to higher morbidity, mortality, health-care utilization and costs. Objective: The aim of the study was to investigate the impact of mental comorbidity and physical multimorbidity on the length-of-stay in medical inpatients at a maximum-care university hospital. Design The study follows a retrospective, quantitative cross-sectional analysis approach to investigate mental comorbidity and physical multimorbidity in internal medicine patients. Patients: The study comprised a total of n = 28.553 inpatients treated in 2017, 2018 and 2019 at a German Medical University Hospital. Main measures Inpatients with a mental comorbidity showed a median length-of-stay of eight days that was two days longer compared to inpatients without a mental comorbidity. Neurotic and somatoform disorders (ICD-10 F4), behavioral syndromes (F5) and organic disorders (F0) were leading with respect to length-of-stay, followed by affective disorders (F3), schizophrenia and delusional disorders (F2), and substance use (F1), all above the sample mean length-of-stay. The impact of mental comorbidity on length-of-stay was greatest for middle-aged patients. Mental comorbidity and Elixhauser score as a measure for physical multimorbidity showed a significant interaction effect indicating that the impact of mental comorbidity on length-of-stay was greater in patients with higher Elixhauser scores. Conclusions: The findings provide new insights in medical inpatients how mental comorbidity and physical multimorbidity interact with respect to length-of-stay. Mental comorbidity had a large effect on length-of-stay, especially in patients with high levels of physical multimorbidity. Thus, there is an urgent need for new service models to especially care for multimorbid inpatients with mental comorbidity.
Item Description:Veröffentlicht: 22. Juni 2023
Gesehen am 18.08.2023
Physical Description:Online Resource
ISSN:1932-6203
DOI:10.1371/journal.pone.0287234

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