Fontalba-Navas A, Pozo Muñoz F, Garcia Cisneros R, Garcia Larrosa MJ, Callejon Gil MDM, Garcia Delgado I, Jimenez Martinez MB. Challenges and improvement strategies in the hospitalization of chronic multimorbid patients. World J Clin Cases 2025; 13(3): 98284 [DOI: 10.12998/wjcc.v13.i3.98284]
Corresponding Author of This Article
Andres Fontalba-Navas, MD, PhD, Chief Doctor, Professor, Antequera Hospital, Northern Málaga Integrated Healthcare Area, Poeta Muñoz Rojas SN, Antequera 29200, Andalusia, Spain. andres.fontalba.sspa@juntadeandalucia.es
Research Domain of This Article
Health Care Sciences & Services
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 26, 2025; 13(3): 98284 Published online Jan 26, 2025. doi: 10.12998/wjcc.v13.i3.98284
Challenges and improvement strategies in the hospitalization of chronic multimorbid patients
Andres Fontalba-Navas, Francisco Pozo Muñoz, Rogelio Garcia Cisneros, Maria Jose Garcia Larrosa, Maria del Mar Callejon Gil, Ignacio Garcia Delgado, Maria Belen Jimenez Martinez
Andres Fontalba-Navas, Department of Public Health and Psychiatry, University of Málaga, Málaga 29010, Spain
Francisco Pozo Muñoz, Rogelio Garcia Cisneros, Maria Jose Garcia Larrosa, Maria del Mar Callejon Gil, Ignacio Garcia Delgado, Maria Belen Jimenez Martinez, Antequera Hospital, Northern Málaga Antequera Integrated Healthcare Area, Antequera 29200, Málaga, Spain
Author contributions: Fontalba-Navas A, Pozo Muñoz F, Garcia Cisneros R, Garcia Larrosa MJ, Callejon Gil MDM, Garcia Delgado I, Jimenez Martinez MB participated in the design of the study, collected the data, participated in the analysis, interpretation of the data, and drafting of the article; all authors have approved the final version of the manuscript and have read and agreed to the published version of the manuscript.
Supported by Fundación Progreso y Salud, No. AP-0306-2022-C3-F2.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Research Committee of Málaga.
Informed consent statement: Informed consent was obtained from all subjects involved in the study.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: The datasets generated during the current study are available upon reasonable request from the corresponding author. The data will be fully anonymized to ensure participant confidentiality. Data will be available for 5 years following publication and can be accessed by qualified researchers for the purpose of replicating the findings or for additional research. Requests for data access can be submitted to andres.fontalba.sspa@juntadeandalucia.es.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andres Fontalba-Navas, MD, PhD, Chief Doctor, Professor, Antequera Hospital, Northern Málaga Integrated Healthcare Area, Poeta Muñoz Rojas SN, Antequera 29200, Andalusia, Spain. andres.fontalba.sspa@juntadeandalucia.es
Received: June 23, 2024 Revised: September 23, 2024 Accepted: October 15, 2024 Published online: January 26, 2025 Processing time: 141 Days and 17.5 Hours
Abstract
BACKGROUND
Addressing the growing challenge of hospitalizing chronic multimorbid patients, this study examines the strain these conditions impose on healthcare systems at a local level, focusing on a pilot program. Chronic diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient outcomes. If proven effective, this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid patients.
AIM
To evaluate the effectiveness of the high complexity unit (HCU) in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital care.
METHODS
The study employed a descriptive longitudinal approach, analyzing data from the Basic Minimum Data Set (BMDS) to compare hospitalization variables among the HCU, the Internal Medicine Service, and other services at Antequera Hospital throughout 2022. The HCU, designed for patients with complex chronic conditions, integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.
RESULTS
The study employed a descriptive longitudinal approach, analyzing data from the BMDS to compare hospitalization variables among the HCU, the Internal Medicine Service, and other services at Antequera Hospital throughout 2022. The HCU, designed for patients with complex chronic conditions, integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.
CONCLUSION
This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary approach. The coordinated care provided by the HCU results in improved patient outcomes, reduced unnecessary hospitalizations, and better management of patient complexity. The superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction, reinforcing its value as a model of care to be replicated.
Core Tip: This observational study examines the effectiveness of a multidisciplinary care model implemented in the high complexity unit (HCU) for patients with chronic multimorbidity. The HCU model, through personalized and integrated care, significantly reduces unnecessary hospitalizations and improves patient outcomes. The study also highlights how this approach ensures better management of complex chronic conditions compared to standard hospital care, making it a model worth replicating in other healthcare settings.
