Effects of Type 2 Diabetes Mellitus and Hypertension Comorbidity on Number of Hospital Visits and Admissions Among Outpatients at Mwai Kibaki Hospital, Nyeri County, Kenya

Abstract

Introduction: Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are common cardio-metabolic comorbidity of critical public health concern. HTN often co-occurring in 75% of patients with T2DM. Their interaction exacerbates complications and challenges disease management, likely increasing, morbidity, mortality and healthcare utilization. The increased healthcare utilization, leads to increased health expenditure on health system This study aimed to estimate the proportion of patients with HTN and T2DM comorbidity and evaluate the links with hospital visits and admissions. Methodology: An analytic cross-sectional study was conducted on 150 participants selected via stratified random sampling between August and October, 2023. Utilized primary data collected through questionnaire-guided interviews and secondary data from clinical records. Statistical analysis was performed using SPSS version 24.0. Binary logistic regression assessed the association between comorbidity and healthcare utilization, with p-values <_0.05 considered significant. Results: Most participants were over 65 years and above (52.7%), female (56 %) and 44% male, 80.7% married and mostly farmers (41. 3%).In terms of health financing majority used social health insurance (NHIF) (53.3%) and residents of Nyeri County (49.3%). 78.7 % of the participants had HTN-T2DM comorbidity. 91.7% of those comorbidity had >1 admission in a year, mainly due to complications related to HTN (11.3%), T2DM (4.7%), or both (6%). Logistic regression showed the odds those with comorbidity having >1 hospital admissions was 3.8 higher than those with single disease (OR = 3.8, 95% CI = 1.1–13.2, p = 0.029). However, there is no statistically significant association between comorbidity and outpatient hospital visits (OR = 1.2, 95% CI = 0.5–2.8, p = 0.634). Conclusion: While HTN-T2DM comorbidity was strongly associated with increased hospital admissions but did not significantly affect hospital visits, indicating more severe complications requiring inpatient care. Effective management strategies targeting this comorbidity are crucial to mitigate the impact on healthcare systems and patients