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Admission to hospital could be considered a disease

BMJ 2013; 346 doi: (Published 20 May 2013) Cite this as: BMJ 2013;346:f3242
  1. Hugh McIntyre, consultant physician, Conquest Hospital, The Ridge, Hastings, East Sussex TN37 7RD, UK
  1. hugh.mcintyre{at}

We know that being in hospital is risky, but Hugh McIntyre considers whether admission should be considered a disease in itself

A contemporary medical dictionary definition of “disease” is “an impairment of the normal state of the living animal . . . or one of its parts that interrupts or modifies the performance of the vital functions . . . typically manifested by distinguishing signs and symptoms, and is a response to environmental factors (as malnutrition, industrial hazards, or climate), to specific infective agents (as worms, bacteria, or viruses), to inherent defects of the organism . . . or to combinations of these factors.”1

In Western populations, substantial disease leads to hospitalisation, and, increasingly, elderly people have more than one diagnosis. In such patients, multiple drugs and physical and cognitive frailness can combine to create a complex, fragile condition. These people can be vulnerable to considerable decompensation when confronted by even small perturbations such as a fall or mild infection. Admission to hospital carries its own risks at a time of enhanced vulnerability. Even when patients respond to treatment there is a transitional phase immediately after hospital, commonly manifesting as readmission.

Readmission, although considered a …

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