Modelling factors that influence time to discharge of diabetic. Patients: a case study of Kiruddu National Referral Hospital

Abstract

Diabetes is a critical disease that damages almost all the patient's organs, including the heart, liver, kidneys, eyesight, and teeth, among others. They study aimed at investigating the social demographic, life style and clinical factors that influence the time to discharge of diabetes patients. The analysis was conducted on data from Kiruddu National Referral Hospital and a total of 640 records of diabetic in-patients for the period January, 2017 to December 2022. The outcome variable was “time to discharge” In support of the outcome being count data, the Negative Binomial Regression model was utilized to estimate how the independent factors influenced the time to discharge of diabetes patients. These factors included patient’s gender, age category, duration of disease, smoking status, alcohol use, and patients having diabetic foot. The analysis revealed that male diabetic patients tend to have longer hospital stays compared to female patients. Specifically, male patients are expected to have a 10.6% longer time to discharge (IRR=1.106, 95% CI: 1.027 – 1.192, P=0.008). Additionally, patients aged 60-74 years and 74 years and more are expected to have 28% (IRR= 1.28; 95% CI: 1.114 – 1.48; P=0.001) and 31% (IRR= 1.314; 95% CI: 1.122 – 1.314; P=0.001) respectively longer hospital stays compared to those aged 30 years and below. Smoking and alcohol use are also associated with longer hospital stays, with smokers expected to have a 75% longer time to discharge (IRR= 1.755; 95% CI: 1.566 - 1.967, P=0.000) and patients who use alcohol are expected to have a 26% longer time to discharge (IRR = 1.26, 95% CI: 1.128 – 1.407, P= 0.000). Patients with diabetic foot ulcers are expected to have a 14% longer time to discharge (IRR= 1.14; 95% CI = 1.023 - 1.267, P= .017). Duration of the disease didn’t affect the time to discharge (IRR= 1.068, CI: 0.362 – 1.218; P= 0.328). In conclusion, the study revealed that the factors that influence time to discharge of diabetic patients are age, gender, smoking, alcohol use, and the presence of diabetic foot complications.

Thus, the study recommends implementing targeted intervention programs that focus on managing comorbidities and improving overall health in older diabetic patients to reduce hospitalization duration. Healthcare providers should develop gender-specific health initiatives to address poorer health-seeking behaviors and lack of social support among men, including increased health education, peer support groups, and tailored lifestyle modification programs. Additionally, integrating smoking and alcohol cessation programs into diabetes management plans is crucial, as smoking and alcohol use significantly prolong hospital stays among diabetic patients. Therefore, integrating smoking and alcohol cessation programs into diabetes management plans could be crucial. Finally, health care service providers should prioritize prevention and early treatment of diabetic foot ulcers.