This is why the hospital is so busy in the winter

When the days get shorter, everyone starts coughing and sniffling again. People are more susceptible to infections and are hospitalized more often. The pressure on health care increases significantly in the winter. A certain combination of chronic conditions plays a crucial role in this.

Comorbidity – or the presence of a second condition in addition to a primary disease – accounts for much of the added pressure on the health care system each winter. This is because comorbidity is strongly associated with increased risks of hospitalization and death, British scientists write. For example, the study shows that people with a combination of cancer, kidney disease, cardiovascular disease and diabetes type 2 are eleven times more likely to be hospitalized than people without these conditions. In addition, it turned out that people with a combination of kidney disease, cardiovascular disease, depression and osteoarthritis are less than 24 times more likely to die.

‘Winter pressure’ due to cold
‘Winter stress time’ is approaching again. This runs from approximately 1 December to 31 March. The increased pressure on health care during this period arises as patients’ health problems are exacerbated by the cold, seasonal viruses and increasing isolation. In addition, the occupancy rate of hospital beds is much higher and absenteeism due to illness among health care workers is increasing significantly.

By 2035, it is expected that almost 70 per cent of the population of England will suffer from two or more illnesses. Although previous research has linked the increased stress on the health care system to many chronic conditions in winter, it was not clear until now which specific combinations place the greatest burden on the t -system. Therefore, the researchers decided to look for primary and secondary health care data for adults in England during the 2021-2022 winter stress period. This period coincided with the corona pandemic, which obviously had a major impact on health care provision.

A large database
The study used data from 48.3 million people with an average age of 49 years. The researchers selected 59 chronic diseases, which were classified into 19 categories based on feedback from doctors, patients and policy makers.

A total of 4.7 million hospitalizations and 176,895 deaths occurred during the study period. Of the participants, 40.5 percent had no chronic illnesses, 28 percent suffered from one condition, and nearly a third (31 percent) had two or more. After adjusting for factors such as age, gender, ethnicity and socioeconomic status, it turned out that people with cancer, kidney disease, cardiovascular disease and diabetes were eleven times more likely to be hospitalized during the People winter without these. conditions.

The deadliest combination of diseases
In the ten combinations that contributed most to hospitalization, cardiovascular disease occurred nine times, kidney disease eight times, and cancer six times. In the death category, it turned out that people with cardiovascular disease and depression died almost five times more often than those without these conditions. And people with a combination of kidney disease, cardiovascular disease, depression and osteoarthritis were 24 times more at risk.

The researchers point out that cardiovascular disease appears in the ten most deadly combinations, and kidney disease plays a role in seven of these combinations. The combination of cardiovascular disease and depression appears in the five deadliest combinations overall and the risk of mortality is significantly higher than many combinations of conditions triple, quadruple or quintuple.

Recognizing patterns
“Multimorbidity patterns are an important factor in winter hospital admissions and mortality,” said researcher Jonathan Batty from the University of Leeds in an accompanying statement. “It is important to look at the broader context of increasing winter stress and multimorbidity in health care,” the researchers write. “This study reinforces the “There is a need to develop ways to identify people at high risk of hospitalization and mortality. Then it is important to design strategies to reduce the risk for those with the worst combinations.”