Comorbility and recurrent hospitalization in Internal Medicine

Background: Most studies on demographic data from industrialised countries clearly demonstrate a trend towards aging of the population, associated with an increase chronic disorders, often coexisting in the same subject. Consequently, the burden of patients with the above mentioned characteristics is becoming overwhelming for all hospital wards, and especially for those of Internal Medicine. Objectives: Aim of the study is to evaluate the characteristics of the patients admitted to a ward of acute Internal Medicine, the frequency of recurrent admissions in subjects of 65 years and over, and the reasons for readmission. Methods: This is a retrospective analysis of admissions to the General Medicine Department of S. Spirito Hospital (Rome) during the year 2005. The main demographic and clinical characteristics were recorded in each patient aging 65 years or more, hospitalized during the first 3 months of the year, and correlated with the readmission rate during the subsequent nine months. Results: During the first three months of 2005, 259 patients were hospitalized: 195 (75.3%) aged 65 years or more. Forty-seven patients aging 65 years or more (24.1%) were readmitted at least once during the subsequent 9 months. In comparison to older patients who did not require further admissions, those with re-admissions had more frequently three or more concomitant diseases: 40 out of 47 vs. 67 out of 148; Odds ratio = 6.9, 95% confidence intervals: 2.9-16.4, p < 0.0001 (univariate analysis). Conclusions: These data suggest greater relationship between hospital and territory, in order to ensure a continuum in the care of older patients.