The Burden of Hospital Morbidity and Mortality in Ghana: A Four-Year Retrospective Analysis of National Data

BackgroundUnderstanding hospital admission and mortality trends is essential for enhancing health system performance in low- and middle-income countries. In Ghana, systemic challenges such as unequal access to care, workforce shortages, and changing disease patterns - exacerbated by the COVID-19 pandemic - underscore the need for comprehensive health data analysis. This study examines national hospital morbidity and mortality trends from 2019 to 2023, identifying demographic and clinical factors that predict mortality to inform policy and health system reforms. MethodsA retrospective analysis was performed using data from Ghanas District Health Information Management System-2 (DHIMS-2), covering 2,357,535 hospital admissions across 15 regions from 2019 to 2023. Descriptive statistics and multivariate logistic regression were employed to investigate patterns in morbidity, mortality, and associated risk factors, based on patient demographics, insurance status, disease classification (ICD-11), and length of hospital stay. ResultsHospital mortality throughout the study period was 2.6%. Infectious and parasitic diseases were the primary causes of admission (30.1%), while diseases of the nervous system exhibited the highest case fatality rate (13.8%). Mortality was significantly greater from 2020 to 2023 compared with 2019, with the highest odds observed in 2023 (AOR = 1.50; 95% CI: 1.46-1.54). Advanced age ([&ge;]65 years), male sex, lack of insurance, short hospital stays (<1 day), and comorbid conditions were all linked to higher mortality. Admissions due to neoplasms, circulatory, respiratory, and neurological conditions demonstrated notably high adjusted odds of mortality. Conversely, admissions covered by health insurance, female patients, and those with stays of 3-7 days had a reduced mortality risk. ConclusionThis national review highlights ongoing gaps in the health system that lead to hospital mortality, especially for complex conditions and vulnerable groups. While the National Health Insurance Scheme looks protective, disparities still exist across age, sex, region, and disease types. Urgent investments in diagnostic and critical care, along with expanding insurance coverage and regional resource distribution, are needed to reduce preventable hospital deaths in Ghana.