People living with multiple long-term conditions have different pathways of unscheduled care in hospital: findings from an analysis of routinely-collected clinical data
- 1Newcastle University
Abstract
Study ObjectiveLittle is known about where in hospital care for multiple long-term conditions (MLTC) is delivered. We aimed to describe pathways of care (ward transfers) and outcomes for people admitted to hospital for unscheduled care by MLTC status and other key sociodemographic characteristics.
Design and settingAnalysis of routinely-collected electronic health records from a large acute UK hospital.
ParticipantsAdult unscheduled care admissions from 1st July 2018 to 30th June 2019. The presence of two or more of 59 long-term conditions was ascertained using ICD-10 codes from previous hospital discharges.
Main outcome measuresMarkov state transition probabilities were derived for ward moves and compared for MLTC vs no MLTC, age, sex, ethnicity and neighbourhood deprivation. Outcomes (length of stay, death, readmission, move from definitive ward) and time spent in emergency and assessment departments were compared between subgroups.
ResultsA total of 33,252 adults, mean age 56.0 (SD 21.9) years were analysed; 14,834 (42.4%) had MLTC. People with MLTC were more likely to die in hospital (4.2 vs 1.9%, p<0.001), transfer to internal medicine wards or older peoples medicine wards, were less likely to transfer to surgical wards, had longer median length of stay (1.83 vs 0.69 days, p<0.001), stayed longer in acute medical units (15.5 vs 9.6 hours, p<0.001), and were more likely to move from their definitive ward (18.2 vs 16.4%, p=0.002).
ConclusionUnscheduled hospital care pathways are complex and differ for people with MLTC, who have worse outcomes and may be less likely to receive optimal care.
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BibTeX
@misc{witham2026people,
title = {{People living with multiple long-term conditions have different pathways of unscheduled care in hospital: findings from an analysis of routinely-collected clinical data}},
author = {M. Witham and F. Evison and S. Bellass and R. Cooper and S. Gallier and S. Pretorius and E. Sapey and J. Suklan and A. A. Sayer},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.28.26361696},
url = {https://www.medrxiv.org/content/10.64898/2026.08.28.26361696v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - People living with multiple long-term conditions have different pathways of unscheduled care in hospital: findings from an analysis of routinely-collected clinical data
AU - M. Witham
AU - F. Evison
AU - S. Bellass
AU - R. Cooper
AU - S. Gallier
AU - S. Pretorius
AU - E. Sapey
AU - J. Suklan
AU - A. A. Sayer
PY - 2026
DA - 2026/08/28
PB - medRxiv
DO - 10.64898/2026.08.28.26361696
UR - https://www.medrxiv.org/content/10.64898/2026.08.28.26361696v1
AB - Study ObjectiveLittle is known about where in hospital care for multiple long-term conditions (MLTC) is delivered. We aimed to describe pathways of care (ward transfers) and outcomes for people admitted to hospital for unscheduled care by MLTC status and other key sociodemographic characteristics. Design and settingAnalysis of routinely-collected electronic health records from a large acute UK hospital. ParticipantsAdult unscheduled care admissions from 1st July 2018 to 30th June 2019. The presence of two or more of 59 long-term conditions was ascertained using ICD-10 codes from previous hospital discharges. Main outcome measuresMarkov state transition probabilities were derived for ward moves and compared for MLTC vs no MLTC, age, sex, ethnicity and neighbourhood deprivation. Outcomes (length of stay, death, readmission, move from definitive ward) and time spent in emergency and assessment departments were compared between subgroups. ResultsA total of 33,252 adults, mean age 56.0 (SD 21.9) years were analysed; 14,834 (42.4%) had MLTC. People with MLTC were more likely to die in hospital (4.2 vs 1.9%, p<0.001), transfer to internal medicine wards or older peoples medicine wards, were less likely to transfer to surgical wards, had longer median length of stay (1.83 vs 0.69 days, p<0.001), stayed longer in acute medical units (15.5 vs 9.6 hours, p<0.001), and were more likely to move from their definitive ward (18.2 vs 16.4%, p=0.002). ConclusionUnscheduled hospital care pathways are complex and differ for people with MLTC, who have worse outcomes and may be less likely to receive optimal care.
ER -