Understanding Hospital Activity and Outcomes for People with Multimorbidity using Electronic Health Records

As the prevalence of multimorbidity grows, provision of effective healthcare is more challenging. Both multimorbidity and complexity in healthcare delivery may be associated with worse outcomes. We studied consecutive, unique emergency non-surgical hospitalisations for patients over 50 years old to three hospitals in Scotland, UK between 2016 and 2024 using linked primary care and hospital records to define multimorbidity (2 + long-term conditions), and timestamped hospital electronic health record (EHR) contacts with nursing and rehabilitation providers to describe intensity of inpatient care. The primary outcome was emergency hospital readmission within 30 days of discharge, analysed using multivariable logistic regression. Across 98,242 consecutive admissions, 84% of the study population had multimorbidity, 50% had 4 + long-term conditions, and 37% had both physical and mental health conditions.