Spectrum of Diseases, Disease Related Mortality and Overall Financial Burden of Hospitalized Patients in Medical Wards of Tertiary Care Public Hospital

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.