Gray Transformation of Internal Medicine

Abstract

Aim To study the profile of patients hospitalized in an internal medicine facility of a public hospital and explore if there is a shift in the age distribution of hospitalized patients toward an older age group. Methods The study was conducted at a tertiary care hospital in Delhi where the department of medicine has six units and a particular unit is in charge of the emergency room one day a week and every sixth Sunday. A total of 716 patients hospitalized in the medicine ward through the emergency services each Wednesday and every sixth Sunday (i.e, admission days of a particular unit) during a period for six months (November 2017 to April 2018) were retrospectively identified and their name, age, sex, comorbidities, final diagnosis, duration of hospital stay, and the outcome were noted. This was compared with similar data collected from a previous study conducted in the same setting in the years 2010-2011. The data were analyzed using Stata version 13 software (StataCorp, College Station, Texas). Findings were compared using the chi-squared test or t-test, wherever applicable. Results The mean age of patients hospitalized in 2010-2011 was 43.9 years, and this had increased to 48 years in 2018-2019 suggesting that the average patient being hospitalized in general medicine wards of a public hospital was now approximately five years older. Thirty-nine percent (39%) of the individuals admitted were more than 60 years of age in 2018-2019 as compared to 28.0% in 2010-2011. There was a significant rise in the cases of cardiovascular and gastrointestinal diseases and a decline in poisoning and infectious diseases from the year 2010-2011 to 2018-2019. A significantly higher prevalence of cardiovascular diseases, diabetes, and respiratory diseases was found in the current study among older adults. Conclusion There has been a significant shift in the distribution of hospitalized patients in the internal medicine in-patient wards toward the older age group during the last decade. Also, there is a significant difference between the disease profiles of older and young patients. A comprehensive approach to geriatric medicine should be introduced and followed.