Variação na mortalidade e na demora média do internamento por dia de admissão e de alta

TitleVariação na mortalidade e na demora média do internamento por dia de admissão e de alta
Publication TypeArtigo de Periódico
Year of Publication2008
AuthorsLopes, S, Costa, C, Boto, P
JournalRevista Portuguesa de Saúde Pública
Keywordsdemora média, dia de admissão, dia de alta, mortalidade

To date, there is no routine data or reports on the organization of hospital activities, particularly in the inpatient department. However, it is academically possible to expect differences in the availability of human resources during the 24 hours of the day or during the week. The changes expected during the weekend recommend the study of their impact on the outcomes of treatment as well as on its efficiency. This article aims to be a preliminary investigation about the output and about two relevant issues for patients: mortality and length of stay by day of admission or discharge, even though the distribution and intensity of workload are not considered. All inpatient admissions in Portuguese public hospitals during 2006 were considered. The number of admissions, mortality rate and length of stay were calculated by day of admission. Observed values were compared with expected values obtained from Disease Staging’s probability of death or expected length of stay recalibrated to Portuguese data. The same methods were used for day of discharge. Our results indicate that there were 483 more deaths than expected in patients admitted between Friday and Sunday. By day of discharge, 6712 deaths that occurred on Saturday and Sunday were not expected. For patients discharged on Monday, there were 57.160 days over the expected. The highest «weekend effect» was found on mortality and by day of discharge, even after risk adjustment. The relevance of the mortality and of the average length of stay for those involved in the healthcare delivery and, in some cases, the relevance of the differences found point to the need for further research on this subject.

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